Abstract
Lumbar stenosis is a very common degenerative spine condition that can result in radicular and claudication symptoms. Here we describe our experience with a novel midline interspinous process endoscopic decompression procedure that can be performed in awake patients as an outpatient procedure. An interspinous endoscopic lumbar laminectomy and bilateral foraminotomy technique is presented here. A step-by-step technique for accessing the lumbar central canal and bilateral foramina from a midline interspinous approach is presented. A Jamshidi needle, reamers, and side shaving manual drill are used to create an access channel for a 11.5 mm outer diameter tubular retractor. The Joimax rigid laminoscope with a 10 mm diameter and 6 mm working channel was then used to visualize the decompression procedure. The unique technical steps presented here make it possible to safely insert a 11.5 mm outer diameter tubular retractor for a "large" working channel endoscope. The procedure is so minimally invasive, it can be performed with the patient awake.