scholarly journals Transforaminal Percutaneous Endoscopic Lumbar Decompression by Using Rigid Bendable Burr for Lumbar Lateral Recess Stenosis: Technique and Clinical Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shuo Tang ◽  
Song Jin ◽  
Xiang Liao ◽  
Kun Huang ◽  
Jiaquan Luo ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Surgical Procedure ◽  
Leg Pain ◽  
Analog Scale ◽  
Lateral Recess ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
The Mean

Background. Open laminectomy has been regarded as the standard surgical procedure for lumbar lateral recess stenosis during the last decades. Although percutaneous endoscopic lumbar decompression has led to successful results comparable with open decompression, its application in LSS with is still challenging and technically demanding. Here, we report the surgical procedure and preliminary clinical outcomes of transforaminal percutaneous endoscopic lumbar decompression (PELD) by using flexible burr for lumbar lateral recess stenosis. Method. A retrospective study was performed for the patients with lumbar lateral recess stenosis receiving PELD by using flexible burr. The indications of surgery were moderate to severe stenosis, persistent neurological symptoms, and failure of conservative treatment. The patients with mechanical back pain, more than grade I spondylolisthesis, or radiographic signs of instability were not included. Before the operation, the transforaminal epidural lidocaine injections were carried out to make the diagnosis more precise and accurate. Radiologic findings were investigated, and visual analog scale (VAS) for back and leg pain, Oswestry Disability Index, and modified Macnab criteria were analyzed at the different time of preoperation, postoperation, 3 months, 6 months, and 12 months. Results. The follow-up period was 12 months. The mean VAS scores for back and leg pain immediately improved from 7.9 ± 1.2 to 2.8± 1.3, 2.4 ± 1.0, and 2.3 ± 1.0, respectively. The mean visual analog scale scores (VAS) for back pain and leg pain were significantly improved after PELD. The preoperative ODI dropped from 69.1 ± 7.3 to 25.9 ± 8.7, 25.0± 6.9, and 24.7 ± 6.4, respectively. The final outcome was excellent in 39.6%, good in 47.9%, fair in 8.3%, and poor in 4.17%. 87.5% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. The complications were limited to transient postoperative dysesthesia (one case), temporary pain aggravation (six cases), and neck pain during the operation (one case). Conclusion. This observation suggests that the clinical outcomes of PELD for lateral recess stenosis were excellent or showed good results. This minimally invasive technique would be helpful in choosing a surgical method for lateral recess stenosis.

scholarly journals Clinical Outcomes of TESSYS and TESSYS-ISEE Approach on Treatment of Lateral Recess Stenosis: A Comparison Study

2020 ◽  
Author(s):  
Boyu Wu ◽  
Chengjie Xiong ◽  
Biwang Huang ◽  
Dongdong Zhao ◽  
Zhipeng Yao ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Pain Score ◽  
Clinical Outcomes ◽  
Operation Time ◽  
The Elderly ◽  
Leg Pain ◽  
Lateral Recess ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
Short Period

Abstract Background: Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with the increasing age, the percutaneous endoscopic lumbar decompression is advocated. The objective of this study was to compare the clinical outcomes of percutaneous endoscopic lumbar decompression in LRS via TESSYS or TESSYS-ISEE approach. Methods: A total of 45 and 42 consecutive patients with limp or radiculopathy symptoms underwent percutaneous endoscopic lumbar decompression using transforaminal endoscopic spine system (TESSYS) and TESSYS-ISEE, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and Modified MacNab’s criteria. Results: The average values of radiation exposure and operative time in TESSYS group were significantly higher than those in TESSYS-ISEE group (P<0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with before the operation (P<0.05). In addition, the VAS score of the leg and ODI score in the TESSYS-ISEE group were significantly lower than those in TESSYS group at 1 week follow-up (P<0.05). The good-to-excellent rates of the TESSYS and TESSYS-ISEE group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in TESSYS and TESSYS-ISEE groups, respectively. Conclusions: TESSYS-ISEE can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This approach was comparable to the TESSYS approach with improved VAS leg pain and ODI score in short period after operation. However, potential complications and risks still needs to be considered.

scholarly journals Comparative Analysis between Three Different Lumbar Decompression Techniques (Microscopic, Tubular, and Endoscopic) in Lumbar Canal and Lateral Recess Stenosis: Preliminary Report

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Chul-Woo Lee ◽  
Kang-Jun Yoon ◽  
Sang-Soo Ha
Keyword(s):  
Back Pain ◽  
Hospital Stay ◽  
Surgical Outcome ◽  
Operation Time ◽  
Clinical Success Rate ◽  
Decompression Surgery ◽  
Lateral Recess ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
Canal Diameter

Purpose. The purpose of our study is to compare the results of spinal decompression using the full-endoscopic interlaminar technique, tubular retractor, and a conventional microsurgical laminotomy technique and evaluate the advantages and clinical feasibility of minimally invasive spinal (MIS) lumbar decompression technique in the lumbar canal and lateral recess stenosis. Methods. The authors retrospectively reviewed clinical and radiological data from 270 patients who received microsurgical (group E: 72 patients), tubular (group T: 34 patients), or full-endoscopic decompression surgery (group E: 164 patients) for their lumbar canal and lateral recess stenosis from June 2016 to August 2017. Clinical (VAS, ODI, and Mcnab criteria), radiologic (spinal canal diameter, segmental dynamic angle, and disc height), and surgical outcome parameters (CPK level, Operative time, blood loss, and hospital stay) were evaluated pre- and postoperatively and compared among the three groups by means of statistical analysis. Failed cases and complications were reviewed in all groups. Results. The mean follow-up period was 6.38 months. The Overall clinical success rate was 89.4%. All groups showed favorable clinical outcome. The clinical and radiologic results were similar in all groups. Regarding surgical outcome, group E showed longer operation time than group M and T (group E: 84.17 minutes/level, group M: 52.22 minutes/level, and group T: 66.12 minutes/level) (p<0.05). However, groups E and T showed minimal surgical invasiveness compared with group M. Groups E and T showed less immediate postoperative back pain (VAS) (group E: 3.13, group M: 4.28, group T: 3.54) (p<0.05), less increase of serum CPK enzyme (group E: 66.38 IU/L, group M: 120 IU/L, and group T: 137.5 IU/L) (p<0.05), and shorter hospital stay (group E: 2.12 days, group M: 4.85 days, and group T: 2.83 days) (p<0.05). The rates of complications and revisions were not significantly different among the three groups. Conclusions. MIS decompression technique is clinically feasible and safe to treat the lumbar canal and lateral recess stenosis, and it has many surgical advantages such as less muscle trauma, minimal postoperative back pain, and fast recovery of the patient compared to traditional open microscopic technique.

Hybrid Interlaminar Endoscopic Lumbar Decompression in Disc Herniation Combined With Spinal Stenosis

2020 ◽  
Author(s):  
Kuo-Tai Chen ◽  
Kyung-Chul Choi ◽  
Myung-Soo Song ◽  
Hussam Jabri ◽  
Yadhu K Lokanath ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Leg Pain ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
Endoscopic Discectomy ◽  
The Mean

Abstract BACKGROUND Endoscopic spine surgery is an alternative to the traditional treatment of lumbar disc herniation. However, the traditional technique of interlaminar endoscopic approach is challenging and risky in patients with concomitant spinal stenosis. OBJECTIVE To report a modified technique called hybrid interlaminar endoscopic lumbar decompression as an effective treatment. METHODS Patients with combined lumbar disc herniation and lateral recess stenosis undergoing full-endoscopic interlaminar lumbar discectomy were retrospectively studied. The hybrid interlaminar endoscopic discectomy technique, as well as the use of 2 endoscopes with different diameters, is described in detail. The large endoscope is used for the laminotomy procedure, while the small endoscope is used for the discectomy procedure. The demographics and clinical outcomes of the patients are presented. RESULTS A total of 19 patients were included in this study. The mean age was 46.7 yr. The visual analog scale for back and leg pain improved from 5.6 ± 3.4 and 7.5 ± 2.3 to 1.8 ± 1.3 and 1.8 ± 1.6, respectively (P &lt; .001). The mean Oswestry Disability Index improved from 59.9 ± 21.2 preoperatively to 18.2 ± 8.5 postoperatively (P &lt; .001). The follow-up was 8.2 mo on average. No major complications occurred, but 2 patients reported mild postoperative paresthesia. One patient had an early recurrence and underwent repeat endoscopic discectomy. CONCLUSION Full-endoscopic lumbar discectomy provides excellent access to the intracanalicular herniation site of an intervertebral disc. By using the endoscopic technique presented here, surgeons can safely and efficiently achieve adequate decompression in patients with lumbar disc herniation combined with spinal stenosis.

scholarly journals Εμβιομηχανική ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία πριν και μετά την εφαρμογή ειδικών φυσιοθεραπευτικών τεχνικών

2015 ◽  
Author(s):  
Γεώργιος Κρεκούκιας
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Visual Analog Scale ◽  
Oswestry Disability Index ◽  
Degenerative Disease ◽  
Leg Pain ◽  
Low Back ◽  
Greek Version ◽  
Analog Scale ◽  
Disability Questionnaire

Εισαγωγή: οι ασθενείς που πάσχουν από χρόνια οσφυαλγία ως συνέπεια της νόσου του εκφυλισμένου δίσκου, εκτός από πόνο εμφανίζουν επίσης και διαταραχή της βάδισής τους. Ο σκοπός της μελέτης είναι η αξιολόγηση τόσο των κλινικών δεδομένων με την χρήση κλινικών κλιμάκων αξιολόγησης, όπως Oswestry Disability Index Greek version (ODI), Visual Analog Scale for low back pain and leg pain (VAS) και το Roland Morris Disability Questionnaire Greek Version, όσο και των κινητικών και κινηματικών χαρακτηριστικών κατά την ανάλυση βάδισης σε ασθενείς με χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου (Disc Degenerative Disease), πριν και μετά την εφαρμογή των ειδικών φυσιοθεραπευτικών τεχνικών (τεχνικών θεραπείας δια χειρός).Μεθοδολογία: για τις ανάγκες της μελέτης 75 ασθενείς που έπασχαν από χρόνια οσφυαλγία, χωρίστηκαν τυχαία σε 3 ομάδες των 25 η καθεμιά. Η κάθε ομάδα δέχθηκε 5 συνεδρίες που για την πρώτη ομάδα ήταν φυσικοθεραπευτικές τεχνικές δια χειρός, για τη δεύτερη ήταν εικονική θεραπεία και για την τρίτη ήταν κλασική φυσικοθεραπεία (διατατικές ασκήσεις, T.E.N.S. και μάλαξη). Προκειμένου να αξιολογηθεί η αποτελεσματικότητα της κάθε θεραπείας χρησιμοποιήθηκε η οπτική αναλογική κλίμακα του πόνου, 2 ερωτηματολόγια (Oswestry και Roland Morris) και επίσης ένα οπτικοηλεκτρονικό σύστημα καταγραφής και ανάλυσης της βάδισης (κινητικά και κινηματικά δεδομένα)Αποτελέσματα: η ομάδα που δέχθηκε τεχνικές δια χειρός εμφάνισε στατιστικά σημαντική μείωση του πόνου και των επιπέδων δυσλειτουργίας. Σε παρόμοια αποτελέσματα οδήγησε και η εφαρμογή κλασικής φυσικοθεραπείας, αλλά η ελάττωση ήταν σαφώς μικρότερη σε σχέση με την ομάδα των τεχνικών δια χειρός. Η ομάδα που δέχθηκε εικονική θεραπεία, δεν είχε κάποια στατιστικά σημαντική διαφορά στα επίπεδα πόνου και δυσλειτουργίας. Σχετικά με την αξιολόγηση της βάδισης, οι ασθενείς στο σύνολό τους, παρουσίασαν διαταραγμένη βάδιση με διαφορά στα κινητικά και κινηματικά δεδομένα μεταξύ δεξιάς και αριστερής πλευράς. Μετά την εφαρμογή των θεραπειών, μόνο η ομάδα που δέχθηκε τεχνικές δια χειρός έδειξε τάση προς συμμετρία μεταξύ δεξιάς και αριστερής πλευράς.Συμπεράσματα: σε περιπτώσεις ασθενών που πάσχουν από χρόνια οσφυαλγία συνεπεία της νόσου του εκφυλισμένου δίσκου, η εφαρμογή 5 συνεδριών τεχνικών δια χειρός δείχνει να βελτιώνει τόσο τα επίπεδα πόνου όσο και δυσλειτουργίας, καθώς επίσης και παρουσιάζει τάση προς συμμετρία στη βάδιση.

scholarly journals Percutaneous Endoscopic Lumbar Foraminotomy

Neurosurgery ◽  
2014 ◽  
Vol 75 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Yong Ahn ◽  
Hyun-Kyong Oh ◽  
Ho Kim ◽  
Sang-Ho Lee ◽  
Haeng-Nam Lee
Keyword(s):  
Visual Analog Scale ◽  
Oswestry Disability Index ◽  
Visual Analog Scale Score ◽  
Leg Pain ◽  
Foraminal Stenosis ◽  
Analog Scale ◽  
Lumbar Foraminal Stenosis ◽  
Endoscopic Techniques ◽  
Post Surgery ◽  
The Mean

Abstract BACKGROUND: Although several authors have reported the use of endoscopic techniques to treat lumbar foraminal stenosis, the practical application of these techniques has been limited to soft disc herniation. OBJECTIVE: To describe the details of the percutaneous endoscopic lumbar foraminotomy (ELF) technique for bony foraminal stenosis and to demonstrate the clinical outcomes. METHODS: Two years of prospective data were collected from 33 consecutive patients with lumbar foraminal stenosis who underwent ELF. The surgical outcomes were assessed using the visual analog scale, Oswestry Disability Index, and modified MacNab criteria. The procedure begins at the safer extraforaminal zone rather than the riskier intraforaminal zone. Then, a full-scale foraminal decompression can be performed using a burr and punches under endoscopic control. RESULTS: The mean age of the 18 female and 15 male patients was 64.2 years. The mean visual analog scale score for leg pain improved from 8.36 at baseline to 3.36 at 6 weeks, 2.03 at 1 year, and 1.97 at 2 years post-surgery (P &lt; .001). The mean Oswestry Disability Index improved from 65.8 at baseline to 31.6 at 6 weeks, 19.7 at 1 year, and 19.3 at 2 years post-surgery (P &lt; .001). Based on the modified MacNab criteria, excellent or good results were obtained in 81.8% of the patients, and symptomatic improvements were obtained in 93.9%. CONCLUSION: Percutaneous ELF under local anesthesia could be an efficacious surgical procedure for the treatment of foraminal stenosis. This procedure may offer safe and reproducible results, especially for elderly or medically compromised patients.

scholarly journals Clinical outcomes of transforaminal endoscopic lateral recess decompression by using the visualized drilled foraminoplasty and visualized reamed foraminoplasty: a comparison study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Boyu Wu ◽  
Chengjie Xiong ◽  
Biwang Huang ◽  
Dongdong Zhao ◽  
Zhipeng Yao ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Pain Score ◽  
Clinical Outcomes ◽  
Operation Time ◽  
The Elderly ◽  
Leg Pain ◽  
Lateral Recess ◽  
Lateral Recess Stenosis ◽  
Short Period

Abstract Background Lateral recess stenosis (LRS) is a common degenerative disease in the elderly. Since the rise of comorbidity is associated with increasing age, transforaminal endoscopic lateral recess decompression (TE-LRD) is advocated. The objective of this study was to compare the clinical outcomes of TE-LRD in patients with LRS via visualized drilled foraminoplasty (VDF) or visualized reamed foraminoplasty (VRF) technique. Methods A total of 45 and 42 consecutive patients with limp or unilateral radiculopathy symptoms underwent TE-LRD using the VDF and VRF technique, respectively. The radiation exposure and operation time, time to return to work, and complications were compared between two groups. Their clinical outcomes were evaluated with the visual analogue scale (VAS) leg pain score, VAS back pain score, Oswestry Disability Index (ODI) and modified MacNab’s criteria. Results The average values of radiation exposure and operative time in the VDF group were significantly higher than those in the VRF group (P <  0.05). The postoperative VAS and ODI scores in both groups were significantly improved compared with those before the operation (P <  0.05). In addition, the VAS score of the leg pain and ODI score in the VRF group were significantly lower than those in the VDF group at the 1-week follow-up (P <  0.05). The good-to-excellent rates of the VDF group and VRF group were 88.89 and 90.48%, respectively, whereas the complication occurrence rates were 6.67 and 4.76% in the VDF group and VRF group, respectively. Conclusions TE-LRD performed by using VRF technique can be applied to treat LRS safely and effectively with short radiation exposure and operation time. This technique was comparable to the VDF technique with improved VAS leg pain and ODI scores in the short period after the operation. However, potential complications and risks still need to be considered.

scholarly journals The short-term effectiveness of precise safety decompression via double percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lumbar lateral spinal canal (LLSC) stenosis

2020 ◽  
Author(s):  
Yu Wang ◽  
Mingyan Deng ◽  
Hao Wu ◽  
Ye Wu ◽  
Chuan Guo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spinal Canal ◽  
Leg Pain ◽  
X Rays ◽  
Short Term ◽  
Lumbar Decompression ◽  
Postoperative Mri ◽  
Flexion Extension ◽  
The Mean

Abstract Purpose: This prospective study reports on a new technique, namely precise safety decompression via double percutaneous lumbar foraminoplasty (DPLF) and percutaneous endoscopic lumbar decompression (PELD) for lateral lumbar spinal canal (LLSC) stenosis, and its short-term clinical outcomes.Methods: The study analyzed 69 patients with single-level LLSC stenosis simultaneously occurring in both zones 1 and 2 (defined as retrodiscal space and upper bony lateral recess respectively by new LLSC classification) who underwent DPLF–PELD from November 2018 to April 2019. Clinical outcomes were evaluated according to preoperative, three months postoperatively, and last follow-up, via leg pain/low back pain (LBP) visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression, and flexion-extension x-rays at the last follow-up were used to observe lumbar stability.Results: All patients successfully underwent DPLF–PELD, and the stenosis was completely decompressed, confirmed by postoperative MRI and CT. The mean follow-up duration was 13 months (range: 8–17 months). The mean preoperative leg pain VAS score is 7.05 ± 1.04 (range 5–9), which decreased to 1.03 ± 0.79(range: 0–3) at three months postoperatively and to 0.75 ± 0.63 (range: 0–2) by the last follow-up visit(p < 0.05). The mean preoperative ODI was 69.8 ± 9.05 (range: 52–85), which decreased to 20.3 ± 5.52 (range: 10–35) at the third month postoperatively and to 19.6 ± 5.21 (range: 10–34) by the final follow-up visit(p < 0.05). The satisfactory (excellent or good) results were 94.2%. There was one patient with aggravated symptoms, which were relieved after an open surgery. Two patients had a dural tear, and two patients suffered postoperative LBP. No recurrence or segmental instability was observed at the final follow-up.Conclusion: DPLF–PELD could be a good alternative for the treatment of LLSC stenosis patients whose stenosis occurred in both zones 1 and 2.

scholarly journals The short-term effectiveness of precise safety decompression via two-time percutaneous lumbar foraminoplasty (TPLF) and percutaneous endoscopic lumbar decompression (PELD) for lumbar lateral spinal canal (LLSC) stenosis

2020 ◽  
Author(s):  
Yu Wang ◽  
Mingyan Deng ◽  
Hao Wu ◽  
Ye Wu ◽  
Chuan Guo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Spinal Canal ◽  
Good Alternative ◽  
Leg Pain ◽  
Short Term ◽  
Lumbar Decompression ◽  
Postoperative Mri ◽  
Flexion Extension ◽  
The Mean

Abstract Purpose This prospective study reports a new technique: precise safety decompression via two-time percutaneous lumbar foraminoplasty (TPLF) and percutaneous endoscopic lumbar decompression (PELD) for lumbar lateral spinal canal (LLSC) stenosis, and short-term clinical outcomes.Methods 69 patients with single-level LLSC stenosis simultaneously occurred in both zone 1 and 2 who underwent TPLF-PELD from November 2018 to April 2019 were prospectively analyzed. Clinical outcomes were evaluated according to preoperative, 3 months postoperatively and last follow-up via leg pain/low back pain (LBP) visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and the Macnab criteria. The postoperative MRI and CT were used to confirm the complete decompression and flexion-extension X-Ray in last follow-up were used to observe lumbar stability.Results All patients successfully underwent TPLF-PELD and the stenosis was completely decompressed confirmed by post-operative MRI and CT. The mean follow-up duration was 13 months (range, 8-17 months). The mean preoperative leg pain VAS score is 7.05±1.04 (range 5-9), which decreased to 1.03±0.79(range 0-3) at third month postoperatively and to 0.75±0.63 (range 0-2) by the last follow-up visit. The mean preoperative ODI was 69.8±9.05 (range, 52-85), which decreased to 20.3±5.52 (range, 10-35) at the third month postoperatively and to 19.6±5.21 (range, 10-34) by the last follow-up visit. The satisfactory (excellent or good) results were 94.2%. There was 1 patients with aggravated symptoms which relieved after open surgery. 2 patients with dural tear and 2 patients with postoperative LBP. No recurrence and segmental instability was observed in the last follow-up.Conclusion TPLF-PELD could be a good alternative option for the treatment of LLSC stenosis patients whose stenotic region occurred in both zone 1 and 2.

Prompt Return to Work after Bilateral Transforaminal Full-endoscopic Lateral Recess Decompression under Local Anesthesia: A Case Report

2020 ◽  
Author(s):  
Kosuke Sugiura ◽  
Kazuta Yamashita ◽  
Hiroaki Manabe ◽  
Yoshihiro Ishihama ◽  
Fumitake Tezuka ◽  
...  
Keyword(s):  
Return To Work ◽  
Local Anesthesia ◽  
Skin Incision ◽  
Leg Pain ◽  
Lateral Recess ◽  
Canal Stenosis ◽  
Transforaminal Approach ◽  
Lateral Recess Stenosis ◽  
Lumbar Spinal ◽  
Herniated Nucleus Pulposus

AbstractTransforaminal full-endoscopic lumbar diskectomy became established early in the 21st century. It can be performed under local anesthesia and requires only an 8-mm skin incision, making it the least invasive disk surgery method available. The full-endoscopic technique has recently been used to treat lumbar spinal canal stenosis. Here, we describe the outcome of simultaneous bilateral decompression of lumbar lateral recess stenosis via a transforaminal approach under local anesthesia in a 60-year-old man. The patient presented with a complaint of bilateral leg pain that was preventing him from standing and walking, and he had been able to continue his work as a dentist by treating patients while seated. Imaging studies revealed bilateral lumbar lateral recess stenosis with central herniated nucleus pulposus at L4/5. We performed simultaneous bilateral transforaminal full-endoscopic lumbar lateral recess decompression (TE-LRD) under local anesthesia. Both decompression and diskectomy were successfully completed without complications. Five days after TE-LRD, he was able to return to work, and 3 months after the surgery, he resumed playing golf. Full-endoscopic surgery under local anesthesia can be very effective in patients who need to return to work as soon as possible after surgery.

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