Article Figures & Data
Figures
- Figure 1
(a) C-arm-guided localization of the upper articular process of the affected lumbar segment. The working channel is positioned parallel to the intervertebral space and extends to the edge of the lamina. (b) Removal of the ipsilateral lamina up to the attachment of the ligamentum flavum using an endoscopic circular saw or osteotome. (c) Partial resection of the spinous process base, contralateral lamina, and the contralateral facet joint to fully expose the ligamentum flavum. (d) Bilateral removal of the ligamentum flavum, followed by exploration of the central spinal canal and both bilateral nerve roots. (e) Longitudinal resection of the medial aspect of the ipsilateral facet joint to decompress the lateral recess and the ipsilateral intervertebral foramen. (f) Decompression of the contralateral lateral recess up to the contralateral pedicle, allowing for the free exploration of the contralateral nerve root.
- Figure 2
Case presentation of a 42-year-old woman with L5 to S1 lumbar spinal stenosis, presenting with a 3-month history of lower back pain and right lower limb radiculopathy, treated with endoscopic unilateral approach bilateral decompression. (a and b) Preoperative lumbar spine radiographs in anteroposterior and lateral views. (c and d) Preoperative dynamic lumbar spine radiographs in flexion and extension. (e and f) Preoperative magnetic resonance imaging demonstrating L5 to S1 lumbar spinal stenosis. (g and h) Preoperative computed tomography (CT) images confirm L5 to S1 lumbar spinal stenosis. (i) Postoperative lumbar spine CT image obtained 3 days after surgery.
- Figure 3
Endoscopic unilateral approach bilateral decompression procedure. (a and b) C-arm guided placement of the working channel in anteroposterior and lateral views. (c) Hemostasis is achieved using a bipolar spherical radiofrequency ablation electrode. (d) Endoscopic lamina removal using a circular saw. (e) Endoscopic management of the lateral recess using an osteotome. (f) Further lamina removal using a Kerrison rongeur under endoscopic visualization. (g) Resection of the ligamentum flavum using specialized forceps. (h) Endoscopic view of the fully decompressed nerve root.
Tables
Scale Preoperative Postoperative P 3 d 6 mo VAS 7.00 ± 0.35 4.32 ± 0.30 2.68 ± 0.24 <0.001 ODI 50.91 ± 3.30 37.91 ± 2.04 30.95 ± 1.74 <0.001 Abbreviations: ODI, Oswestry Disability Index; VAS, visual analog scale.
Outcome Measure Preoperative Postoperative P Anterior-posterior diameter of the spinal canal 77.82 ± 7.82 143.91 ± 8.25 <0.001 Bilateral lateral recess diameter 32.82 ± 3.94 52.91 ± 5.81 <0.001
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