Conventional posterior open fusion surgeries can achieve wide decompression of neural structures and provide stabilization for surgically treated segm ents, they can also result in extensive destruction of posterior anatomical structures, thereby requiring long periods of recovery.

Minimally invasive surgical techniques have been developed to reduce the damage to surrounding tissues. Microscopic unilateral laminotomy has been used in degenerative lumbar stenosis, with good postoperative outcomes reported. However, disadvantages of a microscopic approach include the need for dissection of muscle and minor difficulties in contralateral visualization in patients who are obese or stocky. Additionally, as the microscopic approach restricts the surgeon’s view to outside the spinal canal and limits the range of motion for surgical instruments, an extensive laminectomy and adjustment of the patient’s position may be necessary to achieve the necessary decompression of the contralateral traversing nerve root during the procedure.

It is difficult to apply to Lumbar spondylolisthesis case

Percutaneous endoscopic lumbar discectomy is a technique for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. The method is indicated in patients with non-sequestrated lumbar disc herniation with an intact lorsal longitudinal ligament. Through a minimum incision about 5~7mm, a special endoscope is inserted into the protruding area of the disc. It is a treatment method that removes only the problem disc compressing nerve by using a laser and high frequency and saves the normal disc as much as possible.

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Unilateral Biportal Endoscopy is a surgical procedure to remove stenosis by inserting an endoscope by drilling two small holes about 4mm. It is a state-of-the-art surgical technique that inserts endoscopes on one side to find the exact cause, while inserting surgical instruments on the other to remove bone fractures in the ligaments and joints, which are the main causes of spinal stenosis.