How I do it: the biportal endoscopic inclined-ipsilateral technique to decompress the lumbar lateral recess.

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Various full-endoscopic techniques have been developed to reach the lateral recess of the lumbar spine. However, specialized surgical tools, including expensive spinal endoscopic systems, and a steeper learning curve to mastering the technique are required. We present a novel target-addressed unilateral biportal endoscopic technique to reach directly the lumbar lateral recess, particularly useful at L4-L5 and L5-S1. The technique follows an inclined-ipsilateral trajectory to preserve the lateral extension of ligamentum flavum and the facet joint as much as possible. This technique was associated with all the advantages of minimally invasive decompressive procedures and outstanding outcomes.