Uniportal Full Endoscopic Contralateral Approach for Lumbar Foraminal Stenosis

In recent years, the incidence of spinal stenosis has increased steeply as the elderly population increases. Lumbar foraminal stenosis is one of the common degenerative lumbar diseases and has a pathology of hypertrophy of facets, hypertrophied ligamentum flavum, facet cysts, spondylolisthesis, osteophytes, and disc herniations. Conventional treatment of this pathology is the spinal fusion surgery. However, especially in old ages, this fusion surgery has risk of complications such as greater blood loss, longer operative time, and high postoperative morbidity. Preservation of the facet joints is the most important factor in successful outcome for non-fusion surgery. Among the minimally invasive spinal surgeries, uniportal endoscopic contralateral interlaminar lumbar foraminotomy is the most advanced endoscopic procedure. This technique can provide direct decompression of the nerve with maximally preserving the patient’s anatomical structures in comparison with the fusion procedure. Uniportal endoscopic contralateral interlaminar lumbar foraminotomy is useful to reduce the lateral wedging instability violation, triple crush decompression, and reduce retraction of dorsal root ganglion. This article introduces the basic concept and technical tips of uniportal endoscopic contralateral interlaminar lumbar foraminotomy.