Only fixation for lumbar canal stenosis.

Sir,

We would like to discuss on the report on “only fixation for lumbar canal stenosis.[1]” Goelnoted that “fixation of the spinal segment can be a rationale form of treatment[1]” and “double insurance” transarticular method of treatment is a simple, safe, and effective method of spinal stabilization.[1]” This work seems to be an additional report to the previously similar publication by Goel on “only fixation for cervical spondylosis.[2]” In fact, the fixation of lumbar spine has many techniques by various available fixators. Of interest, Botelho et al. noted that “it was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine.[3]” Focusing on the use of “double insurance” transarticular method, it seems that Goel successfully used it in his experience.[124] However, the result of spine surgery depends on several factors including to setting, experience of the surgeon as well as the race of the patients.[5] Those factors should be further evaluated. Also, some new additional computer assisted technology might be useful for better alignment of screw for increased stability of the present technique.[6] Finally, not only efficacy but also cost effectiveness of this technique should be further evaluated comparing to other available techniques.