Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS) with a far-lateral and extraforaminal approach for lumbar chondroma: a case report and literature review.

BACKGROUND

Lumbar spinal chondroma (LSC) is a rare benign tumor.Most LSCs are located in the epidural space, and some exhibit a dumbbell-shaped growth pattern. Its presentation mimics lumbar disc herniation, leading to frequent misdiagnosis. While hemilaminectomy has been the conventional treatment, we report a case successfully managed with a novel technique: Arthroscopic-assisted Uni-portal Spinal Surgery (AUSS) via a far-lateral extraforaminal approach. CASE PRESENTATION: We report a 42-year-old male with recurrent left lower limb radicular pain for one year. Preoperative MRI revealed an L4/5 extraforaminal lesion causing nerve compression. Using the AUSS technique through a single far-lateral portal under arthroscopic guidance, complete tumor resection and nerve decompression were achieved. Postoperative imaging and outcomes were assessed (Table 2).

Results

The patient's radicular pain resolved completely postoperatively. Imaging confirmed total tumor excision, adequate decompression, and no radiographic evidence of instability at short-term follow-up. No complications occurred. Histopathology confirmed chondroma.

CONCLUSIONS

The AUSS technique with a far-lateral extraforaminal approach is a safe and effective minimally invasive option for resecting lumbar chondroma. It ensures complete tumor removal and neural decompression while minimizing tissue trauma and promoting rapid recovery, representing a viable minimally invasive alternative to conventional open surgery, particularly suitable for LSCs located in the extraforaminal region.