Navigation-assisted contralateral sublaminar decompression: a facet-preserving strategy for upper lumbar lesions

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Endoscopy

Background:

• Upper lumbar lesions can cause significant radiculopathy.
• Minimizing postoperative instability is crucial, especially in young patients.
• Traditional decompression may risk facet joint integrity.

Purpose of the Study:

• To present a case utilizing navigation-assisted contralateral sublaminar decompression via unilateral biportal endoscopy (UBE).
• To highlight the facet-preserving benefits of this UBE approach for upper lumbar pathologies.
• To demonstrate the technical feasibility and clinical outcomes of this minimally invasive strategy.

Main Methods:

• A 34-year-old male patient with L2-3 radiculopathy due to a cystic lesion underwent the procedure.
• Navigation-assisted contralateral sublaminar decompression using UBE was performed.
• Postoperative imaging was used for quantitative analysis of facet integrity.

Main Results:

• Complete removal of the cystic lesion was achieved.
• Satisfactory neural decompression was confirmed postoperatively.
• Quantitative analysis showed minimal contralateral facet loss, preserving facet integrity.

Conclusions:

• Navigation-assisted contralateral sublaminar UBE is a viable facet-preserving option for upper lumbar lesions.
• This technique effectively achieves neural decompression while minimizing iatrogenic instability.
• The presented case underscores the clinical utility of UBE in managing complex lumbar pathologies.