Aim:Lumbar spinal stenosis (LSS), causes severe pain and functional limitation, it reaches the stage at which it needs to be treated surgically. Decompression is the mainstay of surgical treatment for LSS. Various surgical techniques are employed for decompression. Although there are studies showing the superiority of minimally invasive techniques over laminectomy, these methods have not become the standard treatment yet. Little is known about changes in sagittal alignment following lumbar canal decompression. The objective of this study is to observe the impact of the bilateral decompression (microdecompression) technique, on the biomechanics of the spine in the early postoperative period and observe changes in sagittal balance parameters. Material and Methods:41 patients who underwent bilateral lumbar decompression with a unilateral approach between were followed up for 1 year, and their sagittal balance parameters were measured by performing whole-body radiography. Patients were divided into 3 groups according to their SVA values. The groups’ clinical parameters and sagittal balance parameters were compared.Results:SVA values decreased from 64.8 mm preoperatively to 48.6 mm, lumbar lordosis angle increased from 41.7˚ to 45.9˚. Functional improvements were observed with clinical pain control and an increase in walking distance in these patients. Furthermore, improvements were also observed in compensatory mechanisms, pelvic tilt and knee flexion angles decreased.Conclusion:Bilateral decompression surgery with a unilateral approach is an effective method that causes improvements in sagittal balance parameters and compensation mechanisms in these patients and ensures clinical improvement in these patients.