• Talat Cem Ovalioglu, Aysegul Ozdemir Ovalioglu, Gokhan Canaz, Muslum Gunes, Mert Babur, and Erhan Emel.
• Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry, Istanbul, Turkey.
• World Neurosurg. 2022 Aug 1; 164: e1233-e1242.

BackgroundSpinous process splitting decompression (SPSD) is a minimally invasive surgical technique. We evaluated the clinical and radiological outcomes of SPSD compared with conventional laminectomy for the treatment of degenerative lumbar spinal stenosis.MethodsSPSD was performed in 144 patients (group 1) and conventional laminectomy was performed in 132 patients (group 2) for degenerative lumbar spinal stenosis. Operative time, blood loss, hospital stay, and complications were compared between groups. Functional outcome was evaluated 2 years after surgery by Oswestry Disability Index, visual analog scale for back pain and leg pain, and progress in walking capacity. Spinal anteroposterior diameter and cross-sectional area were assessed by magnetic resonance imaging and computed tomography.ResultsBoth groups showed significant improvement in mean functional outcome scores of Oswestry Disability Index and mean visual analog scale for back and leg pain after surgery (P < 0.001), although the differences in scores between the groups (P > 0.05) were not statistically significant. Walking capacity was reported as "much better" and "moderately better" in 89% of patients in group 1 and 87.8% of patients in group 2 (P > 0.05). On the basis of radiographic findings, satisfactory neurological decompression was achieved in group 1 (72.2% increase in mean spinal anteroposterior diameter, 102.5% increase in cross-sectional area) and group 2 (80.3% in mean spinal anteroposterior diameter, 108.8% increase in cross-sectional area) (P > 0.05).ConclusionsPatients who underwent SPSD for lumbar spinal decompression had comparable functional recovery rates correlated with clinical and radiological improvement to patients who underwent conventional laminectomy.Copyright © 2022 Elsevier Inc. All rights reserved.

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