الفهرس 
ANATOMY OF LUMBAR SPINEOnly 14 pages are availabe for public view
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Abstract
Although the aging of the population is causing a dramatic rise in the incidence of lumbar spinal stenosis, the indications and options for surgical treatment are not clearly defined.
The hallmark of degenerative stenosis is osteophyte enlargement of the inferior articular facets and thickening of the adjacent ligamentum flavum and laminae.Both congenital and acquired changes tend to be localised in the posterolateral elements.
Lumbar spinal stenosis is a diagnosis that is derived from the patient’s medical history. Because the symptoms are dependent on activity and body position, a neurological examination will yield findings only at an advanced stage of disease.
Laminectomy, once the mainstay of treatment for lumbar spinal stenosis, has largely been replaced by less aggressive procedures directed more logically at the sites of neurological compression.
Modified interspinal and partial laminectomy techniques have been developed in the same way as decompression techniques directly through the spinous process. As an alternative to laminectomy, interlaminar fenestration techniques have become established that spare the midline structures and thus the dorsal tension band. All these procedures aim to decompress the nerve roots, by resecting the ligamentum flavum and parts of the medial facet joint.
In our compartive study we achieved comparison between decompressive laminectomy and fenestration avoids potential destabilising effects of laminectomy as blood loss ,operation time and hospital stay can be lower ,all offers more favourable health economics .