The Better Bet for Lumbar Stenosis: Real World Evidence on Tubular vs. Endoscopic Decompression

Lumbar spinal stenosis is a common degenerative condition requiring surgical intervention for patients unresponsive to conservative management. This chapter compares tubular-based microscopic decompression and full-endoscopic decompression techniques, focusing on real-world evidence and surgeon perspectives.<br><br>A comprehensive review of literature and survey data highlights the advantages and limitations of each approach, including clinical outcomes, surgical metrics, patient satisfaction, and technical challenges. While endoscopic techniques offer benefits such as reduced blood loss, faster recovery, and smaller incisions, tubular methods are favored for their familiarity, cost-effectiveness, and reliability in complex cases like multilevel stenosis. Challenges like steep learning curves, high costs, and fluid management in endoscopic methods remain significant barriers to widespread adoption. Insights into practice patterns and surgeon preferences provide a deeper understanding of the contemporary clinical application of these techniques, guiding evidence-based decision-making and future advancements in lumbar stenosis treatment.