Nakajima H, Watanabe S, Honjoh K, et al. - A retrospective study was performed to examine clinical and imaging findings in lumbar spinal canal stenosis (LSS) patients with diffuse idiopathic skeletal hyperostosis (DISH) extending to the lumbar segment and to propose countermeasures for the prevention of revision surgery. Researchers enrolled a sum of 613 consecutive patients with LSS who had undergone posterior decompression without fusion at the hospital and had a minimum follow-up period of 2 years. They evaluated demographic data including the rate of revision surgery, neurological examination using the Japanese Orthopaedic Association score, radiological studies comprised plain lumbar radiography, CT, and high-resolution MRI. The study observed a negative impact of lumbar spinous process-splitting laminotomy, particularly with decompression at a lower segment adjacent to DISH extending to the lumbar segment. The data revealed that surgery sparing the osteoligamentous structures at the midline in such cases, including the spinous process and supra- and interspinous ligaments, should be selected.