Endoscopic ULBD (Unilateral Laminotomy for Bilateral Decompression) in Hyderabad
Endoscopic ULBD is a minimally invasive technique for selected patients with lumbar spinal stenosis. Through a small incision on one side, we decompress both sides of the canal under endoscopic visualization, aiming to relieve pressure on the nerves while preserving stabilizing structures when feasible. Your MRI and symptoms guide whether ULBD is appropriate, and safety remains the first priority.
Who is a candidate?
- Neurogenic claudication (leg pain/heaviness with walking, relief with sitting/leaning forward)
- MRI showing central or lateral recess stenosis at one or more levels
- Functional limitation despite appropriate conservative care (medicines, physiotherapy, posture training; injections in select cases)
- No significant instability or deformity that would change the surgical plan
How the procedure works
- A 6–8 mm incision is made on one side.
- Under X‑ray guidance, a working channel is placed.
- The endoscope provides magnified visualization; thickened ligament and bony overgrowth are removed to free the nerve canals on both sides.
- Hemostasis and closure follow; early walking is encouraged when safe.
Benefits and risks
Potential Benefits
- Smaller incision
- Less muscle disruption
- Earlier mobilization in appropriate patients
- Some qualify for day‑care discharge
Risks
- Infection, bleeding
- Nerve/root injury
- CSF leak
- Incomplete relief
- Recurrence
- Conversion to alternative approach if safety requires
We discuss all alternatives in advance.
Endoscopic vs microscopic ULBD
Both approaches aim to decompress the canal. Endoscopic ULBD uses a tiny portal and camera; microscopic ULBD uses a small incision and operating microscope. We recommend the approach that safely achieves adequate decompression for your anatomy.
Recovery and return to work (typical ranges; individualized)
Day 0
Walk with supervision once fully awake.
Week 1
Gentle walking; avoid heavy lifting, bending, twisting; incision care as advised.
Weeks 2–4
Increase walking distance; begin guided core and hip‑glute rehab after wound check.
Weeks 4–8
Gradual return to field/manual work with a structured plan.
Red flags
Fever, new/worsening weakness, wound drainage—contact the clinic promptly.
Costs and insurance (Hyderabad)
- Many policies cover indicated in‑patient decompression after pre‑authorization.
- Day‑care can reduce costs in eligible cases; room category and policy caps influence the final bill.
- We provide a written estimate after your evaluation and MRI review.
When ULBD may not be preferred
- Significant instability or deformity on imaging
- Stenosis patterns requiring a different technique for safe, complete decompression
- Early in conservative care when non‑surgical therapy is likely to help
Why choose Dr Sayuj Krishnan
- Expertise in endoscopic and minimally invasive decompression techniques
- Safety‑first protocols with detailed pre‑op planning and structured follow‑up
- Patients visit from Malakpet, Koti, Charminar, Himayat Nagar, Abids, Secunderabad, Hitech City, Banjara Hills, Gachibowli, and LB Nagar
Book a Consultation
If walking distance is limited by spinal stenosis, we'll help confirm whether endoscopic ULBD or another approach is best for you. Book a consultation at Yashoda Hospitals – Malakpet and bring your MRI for a tailored plan and recovery timeline.
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References
Disclaimer
Educational content only; treatment decisions are individualized after clinical evaluation and imaging review. No outcome is guaranteed.
Last medically reviewed: October 1, 2025 — Medical reviewer: Dr Sayuj Krishnan, MBBS, DNB Neurosurgery (Direct 6 years)