Microendoscopic Laminotomy Versus Open Interlaminar Decompression for Degenerative Single-Level Lumbar Spinal Stenosis: A Nonrandomized Prospective Cohort Study With Short-term Outcomes

Objective: Conventional decompression is an effective treatment for lumbar spinal stenosis (LSS), but it is associated with greater tissue disruption and perioperative morbidity. Microendoscopic laminotomy (MEL) is intended to reduce surgical morbidity; however, concerns remain regarding operative time and complications such as incidental durotomy. This study compared MEL with conventional interlaminar decompression (CILD) with respect to clinical outcomes, operative parameters, and complication rates.Methods: This nonrandomized prospective cohort study was conducted over 3 years, including 2 years of patient enrollment and 1 year of follow-up. A total of 68 patients with degenerative single-level LSS were included: 34 underwent CILD and 34 underwent MEL. Clinical outcomes were assessed preoperatively and at multiple follow-up time points using the visual analogue scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI). Operative time, intraoperative blood loss, and length of hospital stay were recorded. Complications, including incidental durotomy and reoperation, were also evaluated.Results: The MEL group had significantly lower intraoperative blood loss and shorter hospital stays than the CILD group, although operative time was significantly longer (p<0.001). The MEL group also had significantly better VAS back pain scores at the immediate, 3-month, and 6-month follow-ups, but no significant between-group difference was observed at 1 year. Similarly, ODI scores were significantly better in the MEL group at the immediate and 3-month follow-ups, with no significant differences at later follow-up points. No significant between-group differences were observed in incidental durotomy or reoperation rates.Conclusion: MEL was associated with better early postoperative recovery than CILD but required technical expertise and was associated with a learning curve that may increase the risk of incidental durotomy during initial experience. Late follow-up outcomes were comparable between the groups.