Inside-Out Approach of Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: A Detailed Technical...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar stenosis was previously a contraindication for endoscopic spine surgery.
• Advancements in endoscopic technology and surgical techniques have overcome previous limitations.
• Full-endoscopic lumbar techniques are now standard in advanced spine centers.

Purpose of the Study:

• To describe the inside-out approach for lumbar endoscopic unilateral laminotomy with bilateral decompression (LE-ULBD).
• To evaluate the safety and effectiveness of LE-ULBD for managing lumbar spinal stenosis.
• To assess patient outcomes, including pain, disability, and complications, after 12 months.

Main Methods:

• Retrospective review of 127 patients undergoing LE-ULBD for single-level lumbar spinal stenosis.
• Detailed description of the inside-out surgical approach.
• Analysis of perioperative outcomes, operation time, hospital stay, complications, thecal sac cross-sectional area, Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI).

Main Results:

• The inside-out LE-ULBD approach demonstrated statistically significant improvements in VAS for leg and back pain.
• Significant improvements were observed in the Oswestry Disability Index (ODI).
• The procedure was associated with good, reproducible outcomes.

Conclusions:

• The inside-out LE-ULBD approach is a safe and effective method for lumbar spinal stenosis decompression.
• This technique offers significant clinical benefits for patients with lumbar stenosis.
• Endoscopic spine surgery is now a viable option for managing all types of lumbar stenosis.