Clinical and Radiological Outcomes of Minimally Invasive Versus Open Lumbar Decompression

Background: Lumbar spinal stenosis may produce neurogenic claudication, radicular pain and disability. Minimally invasive decompression aims to preserve posterior soft tissues while achieving adequate neural decompression.Objective: To compare clinical, functional, MRI-based radiological and perioperative outcomes following minimally invasive versus conventional open lumbar decompression.Materials and Methods: This comparative observational study model included 30 patients with degenerative lumbar spinal stenosis (15 per surgical group), at the Department of Orthopedics and Spine, Shriram Spine Hospital, Udaipur, during September 2025–September 2026. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) for leg and back pain, MRI dural sac cross-sectional area (DSCA), operative duration, blood loss, hospital stay and complications were assessed. Three-month outcomes were compared with Welch’s t-test.Results: Postoperative ODI was 18.5 ± 4.5 following minimally invasive decompression and 21.6 ± 8.5 following open decompression (p=0.221). VAS leg pain was 2.1 ± 1.8 versus 2.6 ± 1.7 (p=0.408). Postoperative DSCA was 128.5 ± 16.4 versus 120.6 ± 15.7 mm² (p=0.189). Estimated blood loss was lower after minimally invasive surgery (71.2 ± 19.8 vs 148.1 ± 22.6 mL, p<0.001), as was hospital stay (2.5 ± 0.7 vs 4.1 ± 0.7 days, p<0.001).Conclusion: Both approaches showed improvements in disability, pain and canal dimensions. Minimally invasive decompression had lower blood loss and shorter hospitalization; functional and radiological differences were not statistically significant at three months.