Staged Endoscopic Unilateral Laminotomy for Bilateral Decompression in an Adult Achondroplasia Patient With Multilevel Lumbar Spinal Stenosis: A Case Report

Author: Woo Joo LEE ¹ ; Jihoon HA ; Cheol Wung PARK
Author Information

1. Department of Neurosurgery, Daejeon Woori Spine Hospital, Daejeon, Korea
Publication Type:Case Report
From: Journal of Minimally Invasive Spine Surgery and Technique 2025;10(Suppl 2):S315-S320
CountryRepublic of Korea
Language:English
Abstract: Lumbar spinal stenosis (LSS) is a significant complication of achondroplasia, often requiring surgical intervention. Traditional open decompression has been the standard treatment, but minimally invasive techniques, such as endoscopic unilateral laminotomy for bilateral decompression (ULBD), offer advantages in select cases. This case report describes a 48-year-old man with achondroplasia who presented with severe neurogenic claudication and lower extremity weakness due to multilevel LSS. A staged endoscopic ULBD approach was performed, initially addressing L2–3 and L4–5, followed by the remaining levels one week later. During the second operation, a delayed dural tear was discovered at the previously operated L2–3 level and successfully managed with a dural sealing matrix. Postoperatively, the patient demonstrated significant pain relief and functional improvement. This case highlights the feasibility and benefits of staged endoscopic ULBD in achondroplasia patients with multilevel LSS, as it enabled effective decompression while minimizing structural disruption.