Navigation-assisted contralateral sublaminar decompression: a facet-preserving strategy for upper lumbar lesions.

Navigation-assisted contralateral sublaminar decompression using unilateral biportal endoscopy (UBE) offers a facet-preserving strategy for upper lumbar lesions, particularly in young patients in whom minimizing postoperative instability is critical. The authors present the case of a 34-year-old man with left L2-3 radiculopathy caused by a cystic lesion extending from the subarticular to the foraminal zone. A navigation-assisted contralateral sublaminar UBE approach was selected to achieve adequate neural decompression while preserving facet integrity. Postoperative imaging confirmed complete lesion removal and satisfactory decompression, with minimal contralateral facet loss on quantitative analysis. This video highlights the technical rationale and clinical utility of this approach. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2624.