Lumbar endoscopic discectomy + foraminotomy + canal decompression

What is This Treatment?

Lumbar endoscopic discectomy, foraminotomy, and canal decompression is a minimally invasive spinal surgery applied in selected patients with lumbar hernia along with stenosis in the nerve exit opening or spinal canal. The goal of this procedure is not only to remove the herniated fragment but to simultaneously widen the narrow area where the nerve passes and control removal of ligamentous or bony tissues causing compression. It particularly provides more comprehensive yet limited tissue trauma decompression in cases with foraminal stenosis, lateral recess stenosis, and disc herniation together. It is not suitable for every patient; the degree of stenosis, the anatomy of the level, the presence of spinal instability, and prior surgery history must be evaluated together.

Benefits

• Muscle and skin trauma may be more limited compared to open surgery since work is performed through a small 7-8 mm portal
• Both removal of disc material and widening of the foramen or canal are possible in the same procedure
• In selected cases, postoperative pain, hospital stay duration, and return to daily activity may be more comfortable
• Endoscopic visualization allows targeted evaluation of the nerve root and structures causing compression

Treatment Process

Before surgery, MRI, CT if necessary, and neurological examination determine the exact location of compression. The procedure can be performed under sedation-local anesthesia in selected cases or under general anesthesia in others. The target level is confirmed with fluoroscopy, then a small portal is placed and the area is visualized through the endoscope via the working channel. First, disc herniation is cleaned; then if the nerve exit opening is narrow, foraminotomy is performed, and if ligamentous and bony tissues causing compression in the lateral recess or canal are present, they are carefully removed. So the procedure targets broader decompression than standard endoscopic discectomy. The procedure is completed with small skin closure and the patient is mobilized early.

When is it used?

• Lumbar hernia with foraminal stenosis where discectomy alone may be insufficient
• Selected cases where nerve root is compressed in a narrow space due to lateral recess stenosis
• Situations where ligamentum flavum thickening and disc pathology together cause nerve compression
• Minimally invasive spinal surgery targeting comprehensive decompression through smaller approach when anatomic suitability exists

Recovery and planning

Early mobilization is possible for most patients after this procedure and same-day or next-day discharge can be planned in many cases. Mild pain at the incision site and stiffness in the surgical area may occur in the first days; conversely, early relief is expected in leg pain or nerve compression-related symptoms. However, in patients with high-degree stenosis, long-standing nerve compression, or additional degenerative problems, recovery may be more gradual. During the first weeks, avoid heavy lifting, prolonged sitting, and sudden twisting-bending movements. Appropriate exercise and controlled rehabilitation plan directly affect the success of the surgery.