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Year : 2022  |  Volume : 9  |  Issue : 1  |  Page : 40-46

Endoscopic decompression for lumbar spinal canal stenosis: A technical note

1 Department of Neurosurgery, Seoul Segyro Hospital, Seoul, Korea
2 Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

Correspondence Address:
Kangtaek Lim
Department of Neurosurgery, Seoul Segyro Hospital, 248, Wiryeseo-ro, Songpa-gu, Seoul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joss.joss_37_21

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Laminectomy and fusion were surgical options to decompress neural structures and provide more space for the spinal cord in a stenosis patient with severe leg pain and progressive neurologic signs, such as numbness and weakness. The evolution of endoscopic spinal surgery techniques has created advantages for patients who require a laminectomy. The authors present a unique technique for endoscopic access to the central and lateral recess pathology as a minimally invasive procedure, which provides a good visualization. We performed two cases of endoscopic spinal surgery for single-level and consecutive three-level lumbar spinal canal stenosis using an 8 mm outer diameter, 5.5 mm working channel, 10° angled lens spinal endoscopic system (percutaneous stenoscopic lumbar decompression, MaxMore Spine Company, Unterföhring, Germany). Optimized endoscopic drills, forceps, and Kerrison punch were used to remove bony pathology and ligamentum flavum under direct endoscopic visualization. The first case had a narrow canal space in the L4/L5 segment with severe numbness at the same dermatome and did not respond with adequate conventional treatment. The second case had three-level canal stenosis with severe back pain and leg weakness. The purpose of this paper is to describe the technique, the efficacy, and feasibility of unilateral endoscopic laminectomy and bilateral decompression via posterior approach in lumbar spinal canal stenosis. Moreover, in this article, we present the technical details on endoscopic procedures and the prevention of complications and management during operation for spinal canal stenosis.

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