Background: Decompression through different fenestration techniques may effectively reduce unnecessary tissue damage, and therefore, decrease the incidence of the complications. The use of the surgical microscope or magnification loupe helped a lot to improve outcomes with such techniques. Methods: This study included 40 Adult patients with ligamentous lumbar canal stenosis in the period from July 2015 to August 2016. Patients had either laminectomy or bilateral fenestration. The main outcome measure was pain intensity (Back pain and Leg pain) over a twelve-month period. Other outcome measures included: Duration of operation and length of hospital stay. Results: There was statistically significant difference in the postoperative intensity of leg pain and low back pain between both groups after 12 months, with lower pain intensity in the bilateral fenestration group. Also, there was a statistically significant improvement in leg pain and low back pain in favors of the bilateral fenestration group Conclusion: Bilateral fenestration would provide relief of symptoms in cases of ligamentous lumbar canal stenosis, with less tissue damage and functional preservation of the spine in comparison to lumbar laminectomy.
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