Lumbale Dekompression

Interlaminäre endoskopische laterale Rezessus-Dekompression
Interlaminäre endoskopische laterale Rezessus-Dekompression
Die endoskopische laterale Rezessus-Dekompression ist eine ultra-minimal-invasive Technik zur Entlastung des Nervendrucks, der durch eine spezifische Form der Spinalstenose verursacht wird, bei der der zentrale Kanal offen ist, aber der laterale Rezessus die quer verlaufende Nervenwurzel komprimiert. Diese oft übersehene Pathologie ist eine häufige Ursache einer unilateralen oder bilateralen Radikulopathie. Durch die Nutzung des interlaminären Korridors können Operateur:innen komprimierenden Knochen und komprimierendes Gewebe mit minimaler Schädigung der umliegenden Anatomie präzise entfernen. In der Regel erfahren die Patient:innen kurz nach dem Eingriff eine signifikante Schmerzlinderung und eine verbesserte Beweglichkeit.1 Langzeitstudien deuten darauf hin, dass diese Vorteile von Dauer sind und mit geringen Reoperationsraten einhergehen.2
Referenzen

1. Lee CH, Choi M, Ryu DS, et al. Efficacy and safety of full-endoscopic decompression via interlaminar approach for central or lateral recess spinal stenosis of the lumbar spine: a meta-analysis.
Spine (Phila Pa 1976). 2018;43(24):1756-1764. doi:10.1097/BRS.0000000000002708. Erratum: Spine (Phila Pa 1976). 2019;44(4):E258. doi:10.1097/BRS.0000000000002988
2. Kesornsak W, Kuansongtham V, Lwin KMM, Pongpirul K. Pain improvement and reoperation rate after full-endoscopic decompression for lateral recess stenosis: a 10-year follow-up. Eur Spine J. 2023;32(8):2882-2888. doi:10.1007/s00586-023-07801-6
Interlaminar Endoscopic Lumbar ULBD
Interlaminar Endoscopic Lumbar ULBD
Endoscopic lumbar unilateral laminotomy for bilateral decompression (ULBD) is an ultra-minimally invasive surgical technique that enables decompression of both sides of the spinal canal through a unilateral approach while preserving midline structures and posterior stabilizing elements. This technique is commonly used to treat central and lateral recess lumbar spinal stenosis, where bilateral nerve compression contributes to neurogenic claudication and radiculopathy, often resulting in leg pain, numbness, weakness, and difficulty walking. By using the interlaminar corridor, surgeons can perform an “over-the-top” decompression to remove compressive bone and ligamentous tissue with minimal disruption to surrounding anatomy.

Research has shown that patients can experience clinically meaningful improvements in pain and function following surgery.1 Prospective randomized studies have demonstrated that full-endoscopic interlaminar decompression provides clinical outcomes comparable to those of conventional microsurgical techniques, while offering potential advantages such as less tissue disruption, lower complication rates, shorter hospital stays, and faster postoperative recovery.2-4
References

1. Lee CH, Choi M, Ryu DS, et al. Efficacy and safety of full-endoscopic decompression via interlaminar approach for central or lateral recess spinal stenosis of the lumbar spine: a meta-analysis.
Spine (Phila Pa 1976). 2018;43(24):1756-1764. doi:10.1097/BRS.0000000000002708

2. Komp M, Hahn P, Oezdemir S, et al. Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study.
Pain Physician. 2015;18(1):61-70.

3. McGrath LB, White-Dzuro GA, Hofstetter CP. Comparison of clinical outcomes following minimally invasive or lumbar endoscopic unilateral laminotomy for bilateral decompression.
J Neurosurg Spine. 2019;30(4):491-499. doi:10.3171/2018.9.SPINE18689

4. Perez-Roman RJ, Gaztanaga W, Lu VM, Wang MY. Endoscopic decompression for the treatment of lumbar spinal stenosis: an updated systematic review and meta-analysis.
J Neurosurg Spine. 2021;36(4):549-557. doi:10.3171/2021.8.SPINE21890