Evolving Role of Lumbar Decompression: A Narrative Review

Traditional open lumbar decompression techniques have long been used to relieve spinal canal pressure caused by lumbar spinal stenosis. However, these procedures are associated with significant postoperative pain and prolonged recovery. Over the past few decades, there has been a shift toward minimally invasive surgical (MIS) techniques designed to minimize tissue trauma, postoperative pain, and recovery time. These advancements represent a major step forward, offering smaller incisions and direct visualization of the spinal canal. Despite the clear benefits of MIS and endoscopic techniques, they also present challenges such as a steep learning curve for surgeons and a risk of incomplete decompression. The present review examines the historical progression from open to MIS and endoscopic lumbar decompression techniques, assessing their clinical outcomes, benefits, and limitations. It highlights the ongoing need for careful application of these methods based on individual patient factors and emphasizes the importance of balancing innovative techniques with evidence-based practices to enhance patient care in spine surgery. The future of lumbar decompression will likely be shaped by further technological advancements, including navigation systems, robotic assistance, and augmented reality, which promise to improve surgical precision and outcomes.