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}