{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:09:45Z","timestamp":1783944585884,"version":"3.55.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To summarize the clinical effect of a single-center retrospective analysis of the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 25 patients who underwent ipsilateral decompression surgery via a contralateral approach with microscope and tubular retractor system, performed by one surgeon at a single center were retrospectively examined. The width of the lamina fenestration was compared with the preoperative distance from the root of the spinous process to the dorsal articular facet, the bilateral articular facet change in the suprapedicle notch section on CT scan, and with the changes in transverse and sagittal diameters of the canal area on MRI. Clinical efficacy was assessed using the Japanese Orthopedic Association (JOA), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 25 patients were treated and the mean intraoperative time was 82.04\u2009\u00b1\u200912.48\u2009min. There was no nerve injury, cerebrospinal fluid leakage, and infection complications. The postoperative CT revealed that the width of the contralateral laminar fenestration was less than the distance from the root of the spinous process to the dorsal articular facet. The residual widths of the ipsilateral articular facet and contralateral articular facet were greater than 2\/3 of the preoperative articular facet width. The transverse and sagittal diameter of canal were significantly increased. The mean follow-up period was 12\u201316\u2009months, and no recurrence or reoperation incidence were found at the last follow-up. When compared to pre-surgery, the ODI, VAS, and JOA scores were significantly improved after surgery (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on our single-center retrospective observation of 25 cases and combined with previous literature, the contralateral approach with a microscope and tubular retractor system for ipsilateral decompression in patients with lumbar lateral recess stenosis and a narrow spinal canal can reduce damage to the articular processes, and probably more conducive to the postoperative stability of the lumbar spine. This was a single center retrospective analysis with a small sample size and lacked randomized controlled trials (RCTs). However, larger-scale, multicenter RTCs are required for additional validation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1387801","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T04:37:39Z","timestamp":1713328659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Contralateral approach using microscope and tubular retractor system for ipsilateral decompression of lumbar degenerative lateral recess stenosis associated with narrow spinal canal"],"prefix":"10.3389","volume":"15","author":[{"given":"Longfei","family":"Shu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingchun","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feihu","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madiha Zahra","family":"Syeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"326","DOI":"10.3171\/2014.12.SPINE13994","article-title":"Bilateral versus unilateral interlaminar approach for bilateral decompression in patients with single-level degenerative lumbar spinal stenosis: a multicenter retrospective study of 175 patients on postoperative pain, functional disability, and patient satisfaction","volume":"23","author":"Den Boogert","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1016\/j.berh.2009.11.001","article-title":"Lumbar spinal stenosis","volume":"24","author":"Genevay","year":"2010","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1038\/nrneurol.2009.90","article-title":"Lumbar spinal stenosis: syndrome, diagnostics and treatment","volume":"5","author":"Siebert","year":"2009","journal-title":"Nat Rev Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"818","DOI":"10.1056\/NEJMcp0708097","article-title":"Clinical practice: lumbar spinal stenosis","volume":"358","author":"Katz","year":"2008","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.1097\/00007632-199505150-00013","article-title":"Lumbar spinal stenosis: clinical and radiologic features","volume":"20","author":"Amundsen","year":"1995","journal-title":"Spine"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1097\/00007632-199610150-00001","article-title":"The anatomy of the human lumbar ligamentum flavum: new observations and their surgical importance","volume":"21","author":"Olszewski","year":"1996","journal-title":"Spine"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1177\/2192568218770769","article-title":"Degenerative lumbar spine disease: estimating global incidence and worldwide volume","volume":"8","author":"Ravindra","year":"2018","journal-title":"Global Spine J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.14245\/ns.1836038.019","article-title":"Health care burden of spinal diseases in the Republic of Korea: analysis of a Nationwide database from 2012 through 2016","volume":"15","author":"Lee","year":"2018","journal-title":"Neurospine"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1227\/00006123-198811000-00014","article-title":"Relief of lumbar canal stenosis using multilevel subarticular fenestrations as an alternative to wide laminectomy: preliminary report","volume":"23","author":"Young","year":"1988","journal-title":"Neurosurgery"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"669","DOI":"10.3171\/jns.1992.77.5.0669","article-title":"Long-term evaluation of decompressive surgery for degenerative lumbar stenosis","volume":"77","author":"Caputy","year":"1992","journal-title":"J Neurosurg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1055\/s-2007-1022542","article-title":"Comparison of techniques for decompressive lumbar laminectomy: the minimallyinvasive versus the \u201cclassic\u201d open approach","volume":"51","author":"Rahman","year":"2008","journal-title":"Minim Invasive Neurosurg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1055\/s-0030-1262814","article-title":"Complications of endoscopic lumbar decompression surgery","volume":"53","author":"Sairyo","year":"2010","journal-title":"J. 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