Unilateral biportal endoscopic laminectomy with lateral mass screw fixation for treating cervical spinal stenosis

Zhu, Caihong; Deng, Xueqing; Pan, Hao; Zhang, Wei

doi:10.1007/s00701-022-05212-y

Cited by 10 publications

(8 citation statements)

References 4 publications

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“…The authors not only designed a contralateral “Zhang’s portal” to facilitate single level decompression [ 15 ] but also modified an endoscopic expansive laminoplasty for multisegmental stenosis [ 16 ]. In addition, we attempted UBEL combined with the lateral mass screw fixation technique to treat CS with instability [ 17 ]. However, additional iatrogenic injury needs to be considered in the abovementioned techniques.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results

Zhu

Zhou

et al. 2023

Medicina

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Objective: The objective of this study was to introduce a surgical technique for the percutaneous decompression of cervical stenosis (CS) using a unilateral biportal endoscopic approach and characterize its early clinical and radiographic results. Materials and Methods: Nineteen consecutive patients with CS who needed surgical intervention were recruited. All enrolled patients underwent unilateral biportal endoscopic laminectomy (UBEL). All patients were followed postoperatively for >1 year. The preoperative and final follow-up evaluations included the Japanese Orthopedic Association (JOA) score for neurological assessment, visual analogue scale (VAS) for axial pain and C2–C7 Cobb angle for cervical sagittal alignment. The postoperative complications were analyzed. Results: Thirteen males and six females were included in the analysis. The mean follow-up period was 16.3 ± 2.6 months. The mean operative time was 82.6 ± 18.4 min. Postoperative MRI and CT revealed ideal neural decompression of the treated segments in all patients. Preoperative VAS and JOA scores improved significantly after the surgery, and cervical lordosis was preserved on the postoperative images. Conclusions: UBEL was an effective surgical method for CS, which may also minimize iatrogenic damage to the posterior tension band (PTB) and help to maximize the preservation of the cervical lordosis.

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Section: Discussionmentioning

confidence: 99%

Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results

Zhu

Zhou

et al. 2023

Medicina

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“…Recently, studies have described endoscopic surgery with screw fixation. Zhu et al 63,64 attempted the posterior UBE approach for cervical stenosis and performed decompressive laminectomy and unilateral lateral mass screw fixation, and reported that open-door laminoplasty also was possible with UBE. Lvov et al 65 reported endoscope-assisted posterior transarticular standalone screw fixation of C1-2 in traumatic injury patients, and found better pain scale recovery after surgery, less blood loss, and shorter operation time.…”

Section: Cervical Spinementioning

confidence: 99%

The Role and Future of Endoscopic Spine Surgery: A Narrative Review

Kwon

Park

2023

Neurospine

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Many types of surgeries are changing from conventional to minimally invasive techniques. Techniques in spine surgery have also changed, with endoscopic spine surgery (ESS) becoming a major surgical technique. Although ESS has advantages such as less soft tissue dissection and normal structure damage, reduced blood loss, less epidural scarring, reduced hospital stay, and earlier functional recovery, it is not possible to replace all spine surgery techniques with ESS. ESS was first used for discectomy in the lumbar spine, but the range of ESS has expanded to cover the entire spine, including the cervical and thoracic spine. With improvements in ESS instruments (optics, endoscope, endoscopic drill and shaver, irrigation pump, and multiportal endoscopic), limitations of ESS have gradually decreased, and it is possible to apply ESS to more spine pathologies. ESS currently incorporates new technologies, such as navigation, augmented and virtual reality, robotics, and 3-dimentional and ultraresolution visualization, to innovate and improve outcomes. In this article, we review the history and current status of ESS, and discuss future goals and possibilities for ESS through comparisons with conventional surgical techniques.

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“…The endoscope is placed in the view portal to obtain a clear surgical field of vision. Related operating tools, such as the plasma radiofrequency wand, grinding drill, lamina biting forceps, and nerve stripping, are used to complete various surgical operations inside and outside the spinal canal through the work portal [11]. Intraoperative continuous saline irrigation is used to remove bleeding or waste from the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Unilateral biportal endoscopy via two different approaches for upper lumbar disc herniation: a technical note

Shao,

Du,

Zhang

et al. 2024

BMC Musculoskelet Disord

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Background The traditional surgical procedures for upper lumbar disc herniation (ULDH) usually lead to frequent complications. We aim to investigate the clinical efficacy of the unilateral biportal endoscopy (UBE) technique in treating upper lumbar disc herniation (ULDH). Methods From January 2020 to December 2021, the clinical data of 28 patients with ULDH treated with the UBE technique were collected and analyzed for surgery time under UBE, postsurgical drainage, postsurgical hospital stay, and complications. The clinical efficacy was evaluated according to the modified MacNab score, Oswestry disability index (ODI), and visual analogue scale (VAS) of low back pain and lower limb pain before the surgery; one week, one month, and three months after the surgery; and at the last follow-up. Results All patients underwent the UBE surgery successfully. The surgery time under UBE for non-fusion cases was 47.50 ± 11.84 min (monosegment) and 75.00 ± 20.66 min (two segments), while that for fusion cases was 77.50 ± 21.02 min. The postsurgical drainage for non-fusion cases was 25.00 ± 13.94 mL (monosegment) and 38.00 ± 11.83 mL (two segments), while that for fusion cases was 71.25 ± 31.72 mL. The postsurgical hospital stay was 8.28 ± 4.22 days. The follow-up time was 15.82 ± 4.54 months. The VAS score for each time period after the surgery was significantly lower (P < 0.05), while the ODI was significantly higher than that before the surgery (P < 0.05). According to the modified MacNab scoring standard, the ratio of excellent to good was 96.43% at the last follow-up. Two patients experienced transient numbness and pain in their lower limbs and no activity disorder after the surgery, and they recovered after conservative treatment. Conclusions The clinical effect of UBE technique in treating ULDH was reliable. According to the needs of the disease, the interlaminar approach or paraspinal approach of the UBE technique was selected. This technique took into account the effect of treatment, achieved the purpose of minimal invasiveness, and did not require special instruments. Therefore, it has the potential for clinical application.

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Unilateral biportal endoscopic laminectomy with lateral mass screw fixation for treating cervical spinal stenosis

Cited by 10 publications

References 4 publications

Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results

Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results

The Role and Future of Endoscopic Spine Surgery: A Narrative Review

Unilateral biportal endoscopy via two different approaches for upper lumbar disc herniation: a technical note

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