{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T10:33:52Z","timestamp":1782556432917,"version":"3.54.5"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background and Study Objective\u2003One risk of established decompression techniques for lumbar spinal stenosis is the resection of facet joints, especially if they are steeply configured, promoting destabilization. Minimally invasive bilateral crossover decompression aims to preserve the facet joints and thus stability of the spine. The purpose of this study is to demonstrate the feasibility and early results of this technique.<\/jats:p><jats:p>Methods\u2003This retrospective case series includes 10 consecutive patients with lumbar stenosis and steep-angle (&lt;35 degrees) facet joints who were treated with minimally invasive bilateral crossover decompression. Eleven segments were decompressed, most commonly L3\/L4 (63.6%), followed by L1\/L2 and L2\/L3 (18.2% each). The effectiveness of surgical decompression was assessed by self-reporting questionnaires.<\/jats:p><jats:p>Results\u2003After a follow-up of 10.5 months, the Symptom Severity Scale and Physical Function Scale of the Swiss Spinal Stenosis Questionnaire improved by 0.9 (p\u2009&lt;\u20090.05) and 0.7 points, respectively. The mean Oswestry Disability Index improved from 53.9 to 34.6 (p\u2009&lt;\u20090.05). Local and radiating pain under strain showed statistically significant improvement on the Visual Analog Scale (8.9 vs. 5.0 and 8.4 vs. 4.6, respectively). Maximum walking distance increased from 190 to 1,029 m. Apart from one patient requiring surgical decompression of an adjacent segment, there were no reoperations, neurological deteriorations, or other complications.<\/jats:p><jats:p>Conclusion\u2003The results of this study indicate that minimally invasive bilateral crossover decompression is a promising technique for the treatment of spinal canal stenosis. With its design to spare facet joints, it can potentially reduce the risk of spinal instability, especially in patients with steep facet joints.<\/jats:p>","DOI":"10.1055\/s-0040-1718521","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T23:59:38Z","timestamp":1611273578000},"page":"278-284","source":"Crossref","is-referenced-by-count":8,"title":["Facet-Sparing Decompression of Lumbar Spinal Stenosis: The Minimally Invasive Bilateral Crossover Approach"],"prefix":"10.1055","volume":"82","author":[{"given":"Jan Helge","family":"Klingler","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hubbe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Scholz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie T.","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany"},{"name":"Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1056\/NEJMoa0707136","article-title":"Surgical versus nonsurgical therapy for lumbar spinal stenosis","volume":"358","author":"J N Weinstein","year":"2008","journal-title":"N Engl J Med"},{"issue":"03","key":"ref2","first-page":"CD010036","article-title":"Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis","author":"G M Overdevest","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3171\/spi.2005.3.2.0129","article-title":"Outcome after less-invasive decompression of lumbar spinal stenosis: a randomized comparison of unilateral laminotomy, bilateral laminotomy, and laminectomy","volume":"3","author":"C Thom\u00e9","year":"2005","journal-title":"J Neurosurg Spine"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"41","DOI":"10.14245\/kjs.2016.13.2.41","article-title":"Clinical and radiological comparison between ipsilateral and contralateral side canal decompression using an unilateral laminotomy approach","volume":"13","author":"W B Park","year":"2016","journal-title":"Korean J Spine"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1055\/s-2007-1022542","article-title":"Comparison of techniques for decompressive lumbar laminectomy: the minimally invasive versus the \u201cclassic\u201d open approach","volume":"51","author":"M Rahman","year":"2008","journal-title":"Minim Invasive Neurosurg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/BRS.0000000000000136","article-title":"A prospective comparative study of 2 minimally invasive decompression procedures for lumbar spinal canal stenosis: unilateral laminotomy for bilateral decompression (ULBD) versus muscle-preserving interlaminar decompression (MILD)","volume":"39","author":"Y Arai","year":"2014","journal-title":"Spine"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1007\/s00701-016-2804-6","article-title":"Microsurgical unilateral laminotomy for decompression of lumbar spinal stenosis: long-term results and predictive factors","volume":"158","author":"K Sch\u00f6ller","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"issue":"S 03","key":"ref8","first-page":"436","article-title":"Minimally invasive foraminotomy through tubular retractors via a contralateral approach in patients with unilateral radiculopathy","volume":"10","author":"M Alimi","year":"2014","journal-title":"Neurosurgery"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1227\/01.NEU.0000311074.79357.1C","article-title":"Lumbar facet joint angle and its importance on joint violation in lumbar microdiscectomy","volume":"62","author":"S E Celik","year":"2008","journal-title":"Neurosurgery"},{"issue":"07","key":"ref10","first-page":"1325","article-title":"Lumbar facet joint tropism does not accelerate degeneration of the facet joints","volume":"18","author":"J Grogan","year":"1997","journal-title":"AJNR Am J Neuroradiol"},{"issue":"07","key":"ref11","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1097\/00007632-199604010-00004","article-title":"Measurement properties of a self-administered outcome measure in lumbar spinal stenosis","volume":"21","author":"G Stucki","year":"1996","journal-title":"Spine"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/00007632-200201010-00020","article-title":"The reliability of the Shuttle Walking Test, the Swiss Spinal Stenosis Questionnaire, the Oxford Spinal Stenosis Score, and the Oswestry Disability Index in the assessment of patients with lumbar spinal stenosis","volume":"27","author":"R K Pratt","year":"2002","journal-title":"Spine"},{"issue":"23","key":"ref13","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1097\/BRS.0b013e3181fc9daf","article-title":"Internal construct validity of the Swiss Spinal Stenosis questionnaire: Rasch analysis of a disease-specific outcome measure for lumbar spinal stenosis","volume":"36","author":"C M Comer","year":"2011","journal-title":"Spine"},{"issue":"23","key":"ref14","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1097\/BRS.0b013e3181f5e13b","article-title":"Validity and reproducibility of self-report measures of walking capacity in lumbar spinal stenosis","volume":"35","author":"C C Tomkins-Lane","year":"2010","journal-title":"Spine"},{"issue":"14","key":"ref15","doi-asserted-by":"crossref","first-page":"E448","DOI":"10.1097\/01.brs.0000222054.89431.42","article-title":"Cross-cultural adaptation of a German version of the Oswestry Disability Index and evaluation of its measurement properties","volume":"31","author":"H Osthus","year":"2006","journal-title":"Spine"},{"issue":"15","key":"ref16","doi-asserted-by":"crossref","first-page":"532628","DOI":"10.1155\/2015\/532628","article-title":"Accidental durotomy in minimally invasive transforaminal lumbar interbody fusion: frequency, risk factors, and management","volume":"2015","author":"J H Klingler","year":"2015","journal-title":"ScientificWorldJournal"},{"issue":"04","key":"ref17","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/s00586-003-0540-0","article-title":"Influence of graded facetectomy and laminectomy on spinal biomechanics","volume":"12","author":"T Zander","year":"2003","journal-title":"Eur Spine J"},{"issue":"04","key":"ref18","first-page":"337","article-title":"Operative treatment for degenerative lumbar spinal canal stenosis","volume":"70","author":"H Trouillier","year":"2004","journal-title":"Acta Orthop Belg"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3171\/SPI\/2008\/8\/2\/193","article-title":"A minimally invasive technique for L5-S1 intraforaminal disc herniations: microdiscectomy with a tubular retractor via a contralateral approach","volume":"8","author":"J S Yeom","year":"2008","journal-title":"J Neurosurg Spine"},{"issue":"06","key":"ref20","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1016\/j.jocn.2015.01.013","article-title":"A novel translaminar crossover approach for pathologies in the lumbar hidden zone","volume":"22","author":"C Reinshagen","year":"2015","journal-title":"J Clin Neurosci"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.1097\/BSD.0b013e31822ac4e5","article-title":"Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach","volume":"25","author":"A James","year":"2012","journal-title":"J Spinal Disord Tech"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2017.10.FOCUS17554","article-title":"Defining the minimum clinically important difference for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database","volume":"44","author":"A L Asher","year":"2018","journal-title":"Neurosurg Focus"},{"key":"ref23","first-page":"1007","volume-title":"Minimally invasive posterior approaches to the spine","author":"C W Kim","year":"2011"},{"issue":"07","key":"ref24","doi-asserted-by":"crossref","first-page":"570","DOI":"10.2176\/nmc.oa.2014-0251","article-title":"Bilateral decompression via microscopic tubularcrossing laminotomy (MTCL) for lumbar spinal stenosis: technique and early surgical result","volume":"55","author":"M-H Shin","year":"2015","journal-title":"Neurol Med Chir (Tokyo)"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1718521.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T20:35:04Z","timestamp":1724358904000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1718521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,21]]},"references-count":24,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2021,5,11]]},"published-print":{"date-parts":[[2021,5]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1718521","relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"value":"2193-6315","type":"print"},{"value":"2193-6323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,21]]}}}