How I do it—tubular trans-spinous process muscle-sparing approach for bilateral lumbar microdiscectomy: surgical technique with illustrative video

This video demonstrates our surgical approach for an entirely tubular trans-spinous process bilateral lumbar discectomy. A 47-year-old man presented with 12 months of severe predominantly right L5 radiculopathy. Magnetic resonance imaging revealed a large diffuse disc bulge at L4/5 resulting in bilateral lateral recess and central stenosis. He underwent bilateral discectomies via a trans-spinous process tubular approach. Postoperatively, his pain resolved and was discharged home the following day. Clinical resolution was sustained at 6 weeks. An entirely tubular trans-spinous process technique for lumbar decompression provides excellent bilateral lateral recess exposure through a minimally invasive muscle-sparing approach.