{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T06:35:05Z","timestamp":1789799705068,"version":"4.0.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors report their current experience with their previously published novel form of treatment in 70 cases of lumbar canal stenosis. The treatment consisted of only fixation of the spinal segments by the transarticular screw fixation technique. No bone, ligament, osteophyte, or disc resection was done for spinal canal and neural foraminal decompression. The proposed treatment is based on the concept that vertical instability that results in telescoping of the facets on physical activity forms the nodal point of pathogenesis of lumbar canal stenosis.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n During the period June 2014 to May 2018, 70 patients presenting with the classically described symptoms of lumbar canal stenosis were treated surgically by only fixation of involved spinal segments. Apart from clinical and radiological guides, instability was diagnosed on the basis of physical observation of the status of articulation by direct manipulation of bones of the region. The operation involved transarticular insertion of 2 or 3 screws for each articulation. The Oswestry Disability Index and visual analog scale were used to assess the patients before and after surgery and at follow-up. Additionally, a personalized patient satisfaction score was used to assess the outcome of surgery.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Clinical symptomatic recovery was observed in all patients in the immediate postoperative period. During the average follow-up period, 100% of patients had varying degrees of symptomatic relief. The patient satisfaction score suggested that all patients were very satisfied with the surgical procedure. The transarticular fixation technique provided strong spinal segment fixation and a reliable ground for bone arthrodesis. No patient needed any additional modality of treatment or reoperation for recurrence of symptoms.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Spinal instability is the nodal point of pathogenesis of spinal degeneration\u2013related lumbar canal stenosis. Only fixation of the involved spinal segments is necessary\u2014decompression by bone or soft-tissue resection is not necessary.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2019.2.focus18726","type":"journal-article","created":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T18:49:13Z","timestamp":1556909353000},"page":"E7","source":"Crossref","is-referenced-by-count":39,"title":["Lumbar canal stenosis: analyzing the role of stabilization and the futility of decompression as treatment"],"prefix":"10.3171","volume":"46","author":[{"given":"Atul","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; and"},{"name":"Lilavati Hospital and Research Centre, Bandra, Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashi","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhidha","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhinandan","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravikiran","family":"Vutha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurg Rev","first-page":"477","article-title":"Role of lumbar interspinous distraction on the neural elements","volume":"35","author":"Alfieri A","year":"2012","unstructured":"Alfieri A, Gazzeri R, Prell J, Scheller C, Rachinger J, Strauss C, : Role of lumbar interspinous distraction on the neural elements. Neurosurg Rev 35:477\u2013484, 201222549123"},{"key":"b2","series-title":"J Spinal Disord Tech","first-page":"255","article-title":"Interspinous process devices in the lumbar spine","volume":"20","author":"Bono CM","year":"2007","unstructured":"Bono CM, Vaccaro AR: Interspinous process devices in the lumbar spine. J Spinal Disord Tech 20:255\u2013261, 200717473649"},{"key":"b3","series-title":"Global Spine J","first-page":"57","article-title":"Spine degenerative conditions and their treatments: national trends in the United States of America","volume":"8","author":"Buser Z","year":"2018","unstructured":"Buser Z, Ortega B, D\u2019Oro A, Pannell W, Cohen JR, Wang J, : Spine degenerative conditions and their treatments: national trends in the United States of America. Global Spine J 8:57\u201367, 201829456916"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"2940","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank JCT","year":"2000","unstructured":"Fairbank JCT, Pynsent PB: The Oswestry Disability Index. Spine (Phila Pa 1976) 25:2940\u20132952, 200011074683"},{"key":"b5","series-title":"J Craniovertebr Junction Spine","first-page":"88","article-title":"Beyond radiological imaging: direct observation and manual physical evaluation of spinal instability","volume":"8","author":"Goel A","year":"2017","unstructured":"Goel A: Beyond radiological imaging: direct observation and manual physical evaluation of spinal instability. J Craniovertebr Junction Spine 8:88\u201390, 201728694589"},{"key":"b6","series-title":"J Craniovertebr Junction Spine","first-page":"1","article-title":"Facet distraction-arthrodesis technique: can it revolutionize spinal stabilization methods?","volume":"2","author":"Goel A","year":"2011","unstructured":"Goel A: Facet distraction-arthrodesis technique: can it revolutionize spinal stabilization methods? 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Neurosurg Rev 35:477\u2013484, 201222549123"},{"key":"b2","series-title":"J Spinal Disord Tech","first-page":"255","article-title":"Interspinous process devices in the lumbar spine","volume":"20","author":"Bono CM","year":"2007","unstructured":"Bono CM, Vaccaro AR: Interspinous process devices in the lumbar spine. J Spinal Disord Tech 20:255\u2013261, 200717473649"},{"key":"b3","series-title":"Global Spine J","first-page":"57","article-title":"Spine degenerative conditions and their treatments: national trends in the United States of America","volume":"8","author":"Buser Z","year":"2018","unstructured":"Buser Z, Ortega B, D\u2019Oro A, Pannell W, Cohen JR, Wang J, : Spine degenerative conditions and their treatments: national trends in the United States of America. 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J Craniovertebr Junction Spine 8:88\u201390, 201728694589"},{"key":"b6","series-title":"J Craniovertebr Junction Spine","first-page":"1","article-title":"Facet distraction-arthrodesis technique: can it revolutionize spinal stabilization methods?","volume":"2","author":"Goel A","year":"2011","unstructured":"Goel A: Facet distraction-arthrodesis technique: can it revolutionize spinal stabilization methods? J Craniovertebr Junction Spine 2:1\u20132, 201122013368"},{"key":"b7","series-title":"J Craniovertebr Junction Spine","first-page":"65","article-title":"Facet distraction spacers for treatment of degenerative disease of the spine: rationale and an alternative hypothesis of spinal degeneration","volume":"1","author":"Goel A","year":"2010","unstructured":"Goel A: Facet distraction spacers for treatment of degenerative disease of the spine: rationale and an alternative hypothesis of spinal degeneration. 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J Neurosurg Spine 19:672\u2013677, 201321923239"},{"key":"b16","series-title":"J Craniovertebr Junction Spine","first-page":"193","article-title":"Preliminary experience with lumbar facet distraction and fixation as treatment for lumbar spinal stenosis","volume":"8","author":"Grasso G","year":"2017","unstructured":"Grasso G, Landi A: Preliminary experience with lumbar facet distraction and fixation as treatment for lumbar spinal stenosis. J Craniovertebr Junction Spine 8:193\u2013198, 201729021670"},{"key":"b17","series-title":"World Neurosurg","first-page":"617","article-title":"Interlaminar spacer: a review of its mechanism, application, and efficacy","volume":"74","author":"Lo TP Jr","year":"2010","unstructured":"Lo TP Jr, Salerno SS, Colohan AR: Interlaminar spacer: a review of its mechanism, application, and efficacy. 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