Uniportal Endoscopic Techniques for Lumbar Decompression: Interlaminar Microdiscectomy, Interlaminar Laminectomy, and...

Endoscopic spine surgery enables targeted neural decompression with the least amount of tissue disruption to paraspinal structures compared to other spine surgery techniques. Though with minimal visualization, endoscopic spine surgery can be challenging. This article presents a stepwise overview of three key uniportal lumbar endoscopic techniques: interlaminar microdiscectomy, interlaminar laminectomy, and transforaminal microdiscectomy. Through integrated operative footage, the videos demonstrate indications, portal trajectory, and critical anatomic landmarks unique to each approach.  The interlaminar microdiscectomy technique is illustrated for median and paramedian disc herniations, emphasizing safe ligamentum flavum separation, dural protection, and direct fragment removal under endoscopic visualization. The interlaminar laminectomy segment details the management of central and lateral recess stenosis, highlighting stepwise bone removal, decompression of traversing and exiting roots, and controlled hemostasis within a limited corridor. The transforaminal microdiscectomy sequence demonstrates access through Kambin's triangle, foraminoplasty, and targeted fragment excision without violating the spinal canal. Operative tips focus on portal alignment, irrigation control, and avoidance of nerve injury, supplemented by discussion of ergonomic hand positioning and intraoperative troubleshooting.   Together, these video demonstrations provide a comprehensive visual reference for surgeons transitioning to endoscopic lumbar surgery. By standardizing procedural steps and emphasizing anatomical orientation, this method article aims to enhance reproducibility, expand technical proficiency, and promote the safe adoption of endoscopic decompression for lumbar disc and canal pathology.