Outcome and Complications of Microsurgical Over-the-Top Decompression in Patients With Lumbar Spine Stenosis

Objective: To determine the success and complications of microsurgical over-the-top decompression in patients with lumbar spine stenosis. Methodology: This descriptive case study was carried out in the Department of Neurosurgery, Lady Reading Hospital-MTI, Peshawar, KPK, from July 2023 to July 2024. The study population included patients diagnosed with lumbar spine stenosis, confirmed by MRI or CT imaging, who underwent Unilateral Laminotomy for Bilateral Decompression (ULBD) after failing to respond to at least six months of conservative management. Outcomes were measured using the Visual Analog Scale (VAS) for pain. Complications such as dural tears, infections, and neurological deficits were documented. Results: The mean age of the patients was 57.50 ± 7.154 years, with 58.9% of the patients being male. The most commonly affected spinal level was L4/L5 (42.6%). The mean duration of surgery was 67.55 ± 13.02 minutes. Postoperatively, 74.5% of patients reported significant improvement in leg pain, and 84.4% experienced relief from lower back symptoms. Complications were minimal, with 4.3% of patients experiencing dural tears and 2.8% reporting wound infections. Overall, 91.5% of patients reported no complications. Patient satisfaction rates were high, with the majority expressing satisfaction with the procedure’s outcomes. Conclusion: Microsurgical over-the-top decompression (ULBD) is a safe procedure for lumbar spine stenosis. The procedure resulted in significant improvement in leg pain and back pain symptoms with a low complication rate.