• Sang-Soo Kang, Su-Chan Lee, and Seung-Kook Kim.
• Department of Orthopedic Surgery, Chung Hospital, Seoul, Republic of Korea.
• World Neurosurg. 2019 Sep 1; 129: 49-54.

ObjectiveTo describe a minimally invasive decompression technique for symptomatic spinal epidural lipomatosis using percutaneous biportal endoscopic surgery.MethodsIn this report, we describe the indirect decompressive effect that was gained by partial laminotomy and ligamentum flavectomy under biportal endoscopic view. Direct neural decompression was then performed by removal of proliferated fat. We described the technical process and compared pre- and postoperative radiating leg pain, life quality, and a radiologic grading system of neural compression.ResultsThis technique was performed successfully in 3 patients with idiopathic spinal epidural lipomatosis. Radiating pain was reduced, and functional disability and radiologic compression were improved. Postoperative instability and surgical complications related to the procedure were not observed.ConclusionsPercutaneous spinal endoscopy is a minimally invasive muscle-preserving technique for spinal lipomatosis that achieves neural decompression directly by lipoma removal and indirectly by partial bone and ligament removal.Copyright © 2019 Elsevier Inc. All rights reserved.

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