Lumbar Endoscopic Spinal Decompression

Endoscopic lumbar spinal decompression allows for a minimal approach-related disruption of non-pathologic spinal anatomy and function while concurrently maximizing functional visualization and correction of pathological tissues. To gain mastery of the technique, an advanced understanding of applicable functional neuroanatomy, in particular the lumbar neuroforamen, is essential for successful outcomes. Furthermore, a clear understanding of the various types of disc prolapse pathology in relation to the neuroforamen will result in more optimal surgical outcomes. Developments in endoscopic spinal decompression have included the development of specialized equipment, surgical techniques, improved visualization and access as well as the development of key instruments similar to those used in open spinal decompression. An understanding of the complications and risks of the procedure are essential. Proper training and understanding of both the technique and surgical anatomy, while utilizing a stepwise learning approach and building a protocol for managing complications is essential. Commonly used approaches include the transforaminal approach and the interlaminar approach. The transforaminal approach is subdivided into the outside, as in foraminal, and the inside out, or intradiscal approaches.