Endoscopic Surgical Strategy for Upper Lumbar Disc Herniation With Spinal Canal Stenosis: A Technical Note

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Endoscopy

Background:

• Treating upper lumbar disc herniation (LDH) with spinal canal stenosis is complex.
• Conventional endoscopic methods often require multiple approaches, increasing invasiveness.

Purpose of the Study:

• To describe a novel, single-approach endoscopic technique for simultaneous treatment of upper LDH and lumbar spinal canal stenosis.
• To evaluate the safety and efficacy of full endoscopic lumbar laminectomy via an interlaminar approach.

Main Methods:

• A novel technique using full endoscopic lumbar laminectomy via an interlaminar approach was employed.
• A specially designed retraction tube facilitated access for bilateral LDH removal.
• Endoscope exchange was avoided throughout the procedure.

Main Results:

• The technique allowed safe and minimally invasive removal of central-type upper LDH from both sides.
• The procedure was performed without the need for endoscope exchange, simplifying the surgical workflow.
• This approach addresses both LDH and spinal stenosis effectively.

Conclusions:

• Full endoscopic lumbar laminectomy via an interlaminar approach is a viable, minimally invasive option for upper LDH with spinal stenosis.
• This novel technique simplifies endoscopic spinal surgery, reducing invasiveness and complexity.