Objective:

Spinal stenosis is a common disease with an increasing incidence. The narrowing of the spinal canal is caused by bone and soft tissue degeneration, such as osteophyte formation, facet and ligamentum flavum hypertrophy and disc herniation. Various surgical techniques have been used for the treatment of spinal canal stenosis, including open, tubular, microsurgical decompression and fusion surgery. Here the technique for full-endoscopic interlaminar bilateral decompression of the lumbar spine is presented.

Methods:

Surgical approach, anatomy, pathology, indications and contraindicatios as well as surgical equipment are described.

Results:

With well chosen endoscopic equipment surgical time can be reduced with minimal collateral damage. Clear advantages of the full-endoscopic decompression over open or other mimimally invasive surgery methods are demonstrated in many clinical studies. The endoscopic technique has shown to be effective in spinal canal decompression with good to excellent clinical results. The interlaminar endoscopic approach minimizes iatrogenic injury to the stabilizing anatomic structures while achieving full unilateral and bilateral decompression. A significant improvement in pain and functional outcome scores with low complication rates have been demonstrated.

Conclusions:

This technique is safe for lumbar spinal decompression and more minimally invasive than a microendoscopic approach. However this technique should be performed by surgeons with advanced skills. Endoscopy can become the gold standard for the treatment of canal stenosis in the near future.