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A 47-year-old man presented with 12 months of severe predominantly right L5 radiculopathy. Magnetic resonance imaging revealed a large diffuse disc bulge at L4\/5 resulting in bilateral lateral recess and central stenosis. He underwent bilateral discectomies via a trans-spinous process tubular approach. Postoperatively, his pain resolved and was discharged home the following day. Clinical resolution was sustained at 6 weeks. An entirely tubular trans-spinous process technique for lumbar decompression provides excellent bilateral lateral recess exposure through a minimally invasive muscle-sparing approach.<\/jats:p>","DOI":"10.1007\/s00701-025-06648-8","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T07:25:39Z","timestamp":1755847539000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How I do it\u2014tubular trans-spinous process muscle-sparing approach for bilateral lumbar microdiscectomy: surgical technique with illustrative video"],"prefix":"10.1007","volume":"167","author":[{"given":"Anthony M. 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