Endoscopic Surgical Strategy for Upper Lumbar Disc Herniation With Spinal Canal Stenosis: A Technical Note

Treatment of upper lumbar disc herniation (LDH) with concomitant spinal canal stenosis is challenging. Conventionally, addressing both pathologies endoscopically requires the use of both transforaminal and interlaminar endoscopic systems, which increases surgical invasiveness and procedural complexity. In this study, we adopted a novel technique involving full endoscopic lumbar laminectomy via an interlaminar approach, followed by the application of a specially designed retraction tube. This method allowed safe and minimally invasive removal of central-type upper LDH from both sides without requiring endoscope exchange. In this article, we describe the technical aspects of endoscopic spinal surgery for patients with upper LDH and lumbar spinal canal stenosis.