Microsurgical decompression without laminectomy in lumbar spinal stenosis

Our objectives were to study a/ the clinical results of microsurgical decompression without laminectomy compared to those reported from standard decompression laminectomy in patients with central lumbar spinal stenosis, and b/ if the microsurgical technique could prevent post-operative instability and concomitant symptoms. Twenty-one patients were treated, 11 men and 10 women, aged 47-81 years. Fourteen patients had "pure" stenosis whereas 7 had additional diseases that compounded the symptoms of stenosis. Independent examiners saw the patients pre-operatively and a mean of 27 months post-operatively. Plain X-ray films were taken of 14 patients a mean of 5 years post-operatively to study possible slippage. Among the 14 patients with "pure" stenosis the results were excellent in 13 and fair in 1. Among the 7 with additional diseases the outcome was excellent in 1, fair in 1, unchanged in 3 and worse in 2. The technique did not prevent post-operative slippage, which occurred in 3 of 14 patients. However, the clinical outcome was not related to slippage. We found the microsurgical technique safe and gentle with excellent possibilities for decompression of the complete spinal canal without laminectomy. The results following this procedure were well comparable to or even better than those reported following standard decompression laminectomy.