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Der-Yang Cho, Hung-Lin Lin, Wen-Yuan Lee, and Han-Chung Lee

neurological outcome. Only the methods used by Watanabe and colleagues 48 and Lin et al. 27 eliminated paraspinal muscle injury. We developed a new operative technique by combining spinous process–splitting laminotomy (to spare posterior back muscle injury) with or without discectomy for decompression of degenerative lumbar spinal stenosis. Our study design is similar to the approach used by Watanabe and colleagues and Lin et al., but there are some key differences. We have named this new operative technique after the marmot, a ground rat that tunnels and builds caves

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Francesco Costa, Marco Sassi, Andrea Cardia, Alessandro Ortolina, Antonio De Santis, Giovanni Luccarell, and Maurizio Fornari

= odds ratio. † Hosmer–Lemeshow test (0.909). Discussion Degenerative lumbar spinal stenosis is a common and debilitating spinal disease, which is currently being diagnosed with more frequency; 42 with an increasing elderly population (age > 65 years), the number of patients presenting with symptoms secondary to lumbar stenosis can be expected to increase accordingly. Therefore, treatment of this disease will also increase, because of increasing life expectancy and improvement in perioperative management. Decompressive laminectomy is the standard surgical

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Marcelo Galarza, Anthony P. Fabrizi, Raffaella Maina, Roberto Gazzeri, and Juan F. Martínez-Lage

Sweden is 11% at 10 years—a national analysis of 9,664 operations . Eur Spine J 14 : 659 – 663 , 2005 16 Jönsson B , Strömqvist B : Lumbar spine surgery in the elderly. Complications and surgical results . Spine 19 : 1431 – 1435 , 1994 17 Katz JN , Lipson SJ , Chang LC , Levine SA , Fossel AH , Liang MH : Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis . Spine 21 : 92 – 98 , 1996 18 Katz JN , Stucki G , Lipson SJ , Fossel AH , Grobler LJ , Weinstein JN : Predictors of

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Swei-Ming Lin, Sheng-Hong Tseng, Jiao-Chiao Yang, and Chi-Cheng Tu

, the chimney sublaminar decompression does not require expensive equipment, and it is more cost effective than endoscopic surgery or other minimally invasive operations requiring a three-dimensional navigation system. Conclusions The aforedescribed chimney sublaminar decompression technique is highly effective for neural decompression in patients with degenerative lumbar spinal stenosis. Because the technique is minimally invasive, its benefits include less postoperative wound pain, a shorter postoperative LOS, earlier recovery, and an improved quality of life

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Hugo F. den Boogert, Joost C. Keers, D. L. Marinus Oterdoom, and Jos M. A. Kuijlen

T he prevalence of degenerative lumbar spinal stenosis (DLSS) is rising because of aging populations, and the condition can lead to serious functional disability and a decrease in quality of life among these patients. 8 , 18 , 20 , 44 , 53 , 61 DLSS is currently the most common indication for spinal surgery in patients older than 65 years, 13 , 19 , 20 , 53 , 56 and several studies have shown better surgical results over more conservative therapies. 2 , 5 , 6 , 10 , 25 , 27 , 38 , 63 However, open conventional laminectomy has been criticized because of

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Myung Soo Youn, Jong Ki Shin, Tae Sik Goh, Seung Min Son, and Jung Sub Lee

the resection of synovial cysts and coexisting lumbar spinal stenosis or degenerative spondylolisthesis: an outcome study . Spine (Phila Pa 1976) 29 : 1049 – 1056 , 2004 10.1097/00007632-200405010-00018 15105680 6 Iguchi T , Kurihara A , Nakayama J , Sato K , Kurosaka M , Yamasaki K : Minimum 10-year outcome of decompressive laminectomy for degenerative lumbar spinal stenosis . Spine (Phila Pa 1976) 25 : 1754 – 1759 , 2000 10888941 10.1097/00007632-200007150-00003 7 Inoue H , Ohmori K , Miyasaka K , Hosoe H : Radiographic

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Andrew C. Vivas, Gregory M. Mundis Jr., and Juan S. Uribe

TO THE EDITOR: We read with great interest the article by Shimizu and colleagues 1 ( Shimizu T, Fujibayashi S, Otsuki B, et al. Indirect decompression with lateral interbody fusion for severe degenerative lumbar spinal stenosis: minimum 1-year MRI follow-up. J Neurosurg Spine. 2020;33[1]:27–34 ). In this article, the authors provide 1-year clinical and radiographic outcome data for patients with severe degenerative lumbar spinal stenosis who underwent indirect decompression via lateral interbody fusion. The severity of central stenosis was graded according to

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Takayoshi Shimizu, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, and Shuichi Matsuda

C onventional surgical treatment for symptomatic degenerative lumbar spinal stenosis includes direct posterior decompression with or without fusion and posterior/transforaminal lumbar interbody fusion. 7 , 8 , 19 In 1997, Mayer first described a lateral retroperitoneal transpsoas approach to the anterior disc space. 12 This approach, extreme lateral interbody fusion (LIF), was later modified and reported by Ozgur et al. 16 More recently, Silvestre et al. and some authors introduced the oblique psoas-sparing approach, which is an approach through the corridor

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Ulrike Held, Johann Steurer, Giuseppe Pichierri, Maria M. Wertli, Mazda Farshad, Florian Brunner, Roman Guggenberger, François Porchet, Tamás F. Fekete, Urs D. Schmid, Isaac Gravestock, and Jakob M. Burgstaller

surgery compared with nonoperative treatment in elderly degenerative lumbar spinal stenosis patients. This study delivers strong evidence that surgical treatment is superior to nonoperative treatment. It helps in clinical decision-making, especially when patients suffer for a long time, sometimes over many years, hoping for a spontaneous improvement of their symptoms. In light of these new results, the years with disability can hopefully be reduced by providing adequate treatment at the right time for this ever-growing elderly and frail population. Acknowledgments We

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Jamal Bech Bouknaitir, Leah Y. Carreon, Stig Brorson, and Mikkel Østerheden Andersen

, Suri P , Guermazi A , Hunter DJ . Spinal stenosis prevalence and association with symptoms: the Framingham Study . Spine J . 2009 ; 9 ( 7 ): 545 – 550 . 19398386 10.1016/j.spinee.2009.03.005 2 Kreiner DS , Shaffer WO , Baisden JL , Gilbert TJ , Summers JT , Toton JF , An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update) . Spine J . 2013 ; 13 ( 7 ): 734 – 743 . 10.1016/j.spinee.2012.11.059 23830297 3 Le Huec JC , Charosky S , Barrey C , Rigal J , Aunoble