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While open laminectomy is the gold standard for severe cases, it carries significant risks, especially for older patients. The variable success of non-surgical conservative treatments highlights the need for l minimally invasive interventions. This review compares available surgical options for LSS, with a focus on percutaneous image-Guided lumbar decompression (PILD) and minimally invasive spine (MIS) procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature review of clinical studies on MIS procedures for lumbar stenosis published between 2000 and 2025 was conducted via PubMed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The PILD procedure, which involves the percutaneous removal of hypertrophied ligamentum flavum, has demonstrated statistically significant reductions in pain and improvements in functional mobility in multiple studies, including three Level 1 randomized controlled trials. Pain relief emerges as early as six weeks and is sustained for up to two years, with a low rate of minor complications. Other MIS options include interspinous spacers and endoscopic decompression, which also show positive outcomes in select patient populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PILD procedure is a safe and effective MIS treatment for LSS specifically caused by ligamentum flavum hypertrophy in patients who have failed conservative care. While offering reduced morbidity compared to open surgery, its long-term efficacy relative to other MIS and traditional techniques requires further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11916-026-01554-9","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:06:57Z","timestamp":1790136417000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Surgery for the Treatment of Lumbar Spinal Stenosis: A Comprehensive Review"],"prefix":"10.1007","volume":"30","author":[{"given":"Francesco","family":"Sammartino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Nancy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breanna","family":"Santoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayesh","family":"Vallabh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Noon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"4","key":"1554_CR1","doi-asserted-by":"publisher","first-page":"CD013577","DOI":"10.1002\/14651858.CD013577","volume":"4","author":"CB Oliveira","year":"2020","unstructured":"Oliveira CB, Maher CG, Ferreira ML, Hancock MJ, Oliveira VC, McLachlan AJ, Koes BW, Ferreira PH, Cohen SP, Pinto RZ. 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