ArticleNeurosurgical review2024
New ipsilateral full endoscopic interlaminar approach for L5-S1 foraminal and extraforaminal decompression: technique description and initial case series.
Article in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Simplified Guiding-Rod Positioning Combined With Visual Trephination: A Safe, Easy, and Efficient Technique for Dual-Segment Lumbar Disc Herniation.International journal of spine surgery · 2026Article
- A comparative study of the far lateral approach of uni-portal non-coaxial spinal endoscopic surgery versus percutaneous endoscopic transforaminal discectomy (PETD) for L5/S1 foraminal stenosis with high iliac crest: a retrospective cohort study.International orthopaedics · 2026Article
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9 authors.
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Abstract
backgroundThe L5-S1 interlaminar access described in 2006 by Ruetten et al. represented a paradigm shift and a new perspective on endoscopic spinal approaches. Since then, the spinal community has shown that both the traditional ipsilateral and novel contralateral interlaminar approaches to the L5-S1 foramen are good alternatives to transforaminal access. This study aimed to provide a technical description and brief case series analysis of a new endoscopic foraminal and extraforaminal approach for pathologies at the lumbar L5-S1 level using a new ipsilateral interlaminar approach.
methodsThirty patients with degenerative stenotic conditions at the L5-S1 disc level underwent the modified interlaminar approach. The surgical time, blood loss, occurrence of complications, and clinical outcomes were recorded. The data were compiled in Excel and analyzed using R software version 4.2. All continuous variables are presented as the mean, median, minimum, and maximal ranges. For categorical variables, data are described as counts and percentages.
resultsThirty patients were included in the study. The cohort showed significant improvements in all quality-of-life scores (ODI, visual analog scale of back pain, and visual analog scale of leg pain). Five cases of postoperative numbness and three cases of postoperative dysesthesia have been reported. No case of durotomy or leg weakness has been reported.
conclusionsThe fundamental change proposed by this procedure, the new ipsilateral approach, presents potential advantages to surgeons by overcoming anatomical challenges at the L5-S1 level and by providing surgeon-friendly visualization and access. This approach allows for extensive foraminal and extraforaminal decompression, including the removal of hernias and osteophytosis, without causing neural retraction of the L5-S1 roots while maintaining the stability of the operated level.
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