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Endoscopic Interlaminar Approach for Lumbar 4/5 Ipsilateral and Contralateral Decompression: 2-Dimensional Operative
Roberto J Perez-Roman1, Michael Y Wang1
1Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Operative Neurosurgery (Hagerstown, Md.)
|June 7, 2021
Summary
Endoscopic spine surgery offers benefits like less tissue disruption for lumbar radiculopathy. A unilateral endoscopic approach effectively achieves bilateral decompression for spinal stenosis.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Minimally Invasive Spine Procedures
Background:
- Lumbar radiculopathy commonly stems from nerve root compression due to spondylosis, herniated discs, or ligamentum flavum hypertrophy.
- Surgical decompression is a primary treatment for lumbar radiculopathy, with endoscopic techniques gaining traction due to reduced invasiveness.
Observation:
- A 48-year-old female presented with bilateral lower extremity radicular pain, left-sided predominance, and severe lumbar 4/5 stenosis with a synovial cyst causing foraminal narrowing.
- The case details a 2D video illustrating an endoscopic interlaminar approach for lumbar 4/5 ipsilateral and contralateral decompression.
Findings:
- The unilateral endoscopic approach, utilizing ipsilateral-contralateral technique, successfully achieved bilateral decompression.
- Key procedural elements including patient positioning, surgical workflow, and technique were highlighted for effective decompression.
Implications:
- Endoscopic spine surgery, particularly the unilateral approach for bilateral decompression, presents a viable minimally invasive option for lumbar radiculopathy.
- This technique potentially reduces bony removal and muscle disruption, enhancing visualization and patient outcomes in managing complex lumbar stenosis.
