Full endoscopic uniportal unilateral laminotomy for bilateral decompression in degenerative lumbar spinal stenosis: highlight of ligamentum flavum detachment and survey of efficacy and safety in 2 years of follow-up.

Objective Conventional laminectomy for spine decompression involves inherent complications resulting from perioperative traumatization of posterior structures. Minimally invasive decompression was developed to address these issues. Full endoscopic spine surgery has shifted the paradigm from disc pathology to spinal stenosis by overcoming the limitation of bony procedures with evolving endoscopic instruments. However, a steep learning curve restricts the development of endoscopic decompression. The purpose of this study is to describe full endoscopic uniportal unilateral laminotomy for bilateral decompression through the interlaminar approach and to evaluate its efficacy and safety in 2 years of follow-up. Methods A total of 106 patients (45 men, 61 women) with degeneration lumbar stenosis involving 165 segments were enrolled from April 2015 to June 2017, and treated by full endoscopic uniportal unilateral laminotomy for bilateral decompression. We made an 8-mm incision and used a general-size endoscope (working channel 4.3 mm) to avoid neurological compromise during the demonstration. Results The visual analogue scale (VAS) results for back pain revealed a significant reduction from preoperative 6.8 ± 2.1 to 1.7 ± 1.7 after 2 years (P Conclusions This procedure obtained successful and satisfactory outcomes for patients, and was more feasible for surgeons.