How I do it? Uniportal full endoscopic contralateral approach for lumbar foraminal stenosis with double crush syndrome

Acta Neurochir (Wien). 2020 Feb;162(2):305-310. doi: 10.1007/s00701-019-04157-z. Epub 2019 Dec 10.

Abstract

Background: Evolution of endoscopic surgery provides equivalent results to open surgery with advantages of minimal invasive surgery. The literature on technique Uniportal Full endoscopic contralateral approach is scarce.

Methods: The endoscopic contralateral approach technique applies for patients presenting with double crush syndrome with foraminal and extraforminal stenosis. The key steps focus on contralateral ventral overriding superior articular process decompression, foraminal and extraforaminal discectomy, and lateral vertebral syndesmophyte decompression leading to enlargement of the contralateral foramen and extraforamen size.

Conclusion: The Uniportal Full endoscopic contralateral approach is a good alternative to open surgery or minimally invasive microscopic surgery through direct endoscopic visualization of the entire route of exiting nerve with no neural retraction allowing both lateral recess and foraminal and extraforaminal decompression all in one approach.

Keywords: Contralateral approach; Degenerative spine; Endoscopic spine; Foraminal stenosis; Minimally invasive spine; Spinal stenosis; Spine decompression; Uniportal endoscopy.

MeSH terms

  • Crush Syndrome / surgery*
  • Diskectomy / methods*
  • Endoscopy / methods*
  • Humans
  • Lumbar Vertebrae / surgery*
  • Spinal Stenosis / surgery*