Surgical treatment of lumbar spinal stenosis with microdecompression and interspinous distraction device insertion. A case series

I read with great interest the manuscript by Avraam Ploumis et al; Surgical treatment of lumbar spinal stenosis with micro- decompression and interspinous distraction device insertion. A case series.I must congratulate the authors for this study. However, I would like to draw attention of authors and readers to the following:

Two different therapeutic options of micro decompression and interspinous decompression have been used together in the study. Hence it will be difficult to evaluate and quantify whether the benefits gained out of the treatment are due to, which of the two therapies. A randomized comparative study, comparing the two different therapeutic modality with nonoperative treatment will be more informative.