Unilateral Biportal Percutaneous Transforaminal Endoscopic Lumbar Foraminal Decompression and Discectomy: A Technical Note

Gandham, Edmond Jonathan; Uvaraj, Nalli Ramanathan; Eum, Jin Hwa

doi:10.4103/0028-3886.344669

Cited by 4 publications

(2 citation statements)

References 1 publication

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“…Others have also found that foraminal decompression using the UBE technique in various foraminal stenosis can preserve the motion of the L5 to S1 facet joint and decrease the need for fusion surgery. [35–37] In case 3, a highspeed diamond burr could not only remove the metal rod occupying the working space but also drill the hypertrophic osteophyte in the foraminal area. Additionally, sufficient decompression of the L5 root was confirmed after the pulsation was observed, and the patient achieved full symptomatic relief.…”

Section: Discussionmentioning

confidence: 99%

A case report: Unilateral biportal endoscopic revision for adjacent segmental disease: Case presentations and literature review

Zhu,

Zhang,

Sun

et al. 2023

Medicine

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Rationale: Biportal endoscopic revision surgery for adjacent segmental disease (ASD) after lumbar arthrodesis is seldomly reported. Herein, we present 3 cases of ASD with radiculopathy wherein satisfactory results were obtained using unilateral biportal endoscopic (UBE) decompression. Patient concerns: Case 1 was of a 56-year-old male who presented with a chief complaint of Intermittent claudication since 2-year. Case 2 involved a 78-year-old female who was admitted to the hospital with a chief complaint of radiating pain and weakness in the left leg for at least 1 year. Case 3 was a 67-year-old woman who visited our hospital because of radiating leg pain for 5 months. All the cases had a history of L4 to L5 lumbar interbody fusion surgery. Diagnoses: Computed tomography and magnetic resonance imaging showed the spinal epidural lipomatosis at the L3 to L4 level in case 1, the up-migrated lumbar disc herniation at L3 to L4 level in case 2 and unilateral foraminal stenosis at the L5 to S1 level in case 3. Interventions: Under UBE guidance, the ipsilateral approach was used to treat adjacent lumbar stenosis caused by spinal epidural lipomatosis. The contralateral approach was used to remove the up-migrated herniated disc. The paraspinal approach was applied to decompress the foraminal stenosis. Outcomes: Postoperative parameters were improved clinically, and nerve roots were decompressed radiologically. No complications were developed. Lessons: UBE revision surgery showed a favorable clinical and radiological result without complications and may be a safe and effective alternative technique for ASD.

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Section: Discussionmentioning

confidence: 99%

A case report: Unilateral biportal endoscopic revision for adjacent segmental disease: Case presentations and literature review

Zhu,

Zhang,

Sun

et al. 2023

Medicine

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“…MISS techniques, known for smaller incisions and reduced tissue disruption, inherently lessen postoperative pain and speed up recovery. [12][13][14][15][16][17][18][19][20][21] However, the role of adaptive training remains crucial, albeit with a modified focus. In the context of MISS, preoperative training can be more targeted towards educating patients about postoperative care, mobility, and self-care techniques.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Preoperative Adaptive Training on Postoperative Outcomes in Lumbar Spine Fusion Surgery for Lumbar Disc Herniation: A Retrospective Analysis

Lu,

Guo,

Liu

et al. 2024

JPR

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Purpose Lumbar disc herniation, often treated with surgical decompression when conservative measures fail, presents challenges due to prolonged prone positioning in surgeries. This retrospective study evaluates the benefits of preoperative adaptive training to mitigate post-surgical physiological changes. Patients and Methods A review of medical records from June 2021 to March 2023 identified 170 patients unresponsive to conservative treatments. Grouped into adaptive training and control groups based on historical data, the former had undergone exercises to prepare for surgery and postoperative changes. Vital signs and VAS scores were extracted from patient records to assess training impact. Results The adaptive training group demonstrated stabilized vital signs intraoperatively, with a notable improvement in surgical exposure compared to the control group. However, there were no significant differences in operative time or blood loss between the groups. Additionally, postoperative VAS scores showed no significant improvement in the adaptive training group at follow-up intervals of 14 days, 1 month, and 3 months post-operation, compared to the control group. Conclusion Our study reveals that preoperative adaptive training stabilizes intraoperative blood pressure fluctuations in lumbar disc herniation surgeries. However, this stabilization does not significantly impact long-term postoperative pain management. This highlights the need for further research to explore comprehensive strategies that effectively combine preoperative training with postoperative care.

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Clinical efficacy of unilateral biportal endoscopy in the treatment of lumbar disc herniation

Zhu,

Yang,

Xia

et al. 2023

Preprint

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Background With the advancement of minimally invasive spinal surgery, the use of unilateral biportal endoscopy (UBE) is gradually being implemented in clinical practice. The objective of this study was to assess the clinical efficacy and imaging results of UBE and fenestration discectomy (FD) in the treatment of lumbar disc herniation (LDH). Methods A retrospective analysis was performed on the data of 50 patients who underwent surgery for LDH in the Spinal Surgery Department of the Sixth Affiliated Hospital of Nantong University from June 2020 to December 2021, including 30 patients in the UBE group and 20 patients in the FD group. The two groups' operation time, incision length, postoperative hospital stay, and postoperative complications were compared. Back visual analog scale (VAS) and Oswestry disability index (ODI) preoperatively, 3 months, and 1 year postoperatively. Leg VAS preoperatively and 3 days, 3 months, and 1 year postoperatively improved the MacNab standard 1 year postoperatively. The superior lamina preservation rate (SLPR) and facet preservation rate (FPR) were calculated by lumbar three-dimensional CT reexamination 3 days postoperatively. Lumbar MRI was re-examined 3 months and 1 year postoperatively to calculate intervertebral disc height (IDH). Results There were no significant differences in sex, age, disease course, lesion space, prominence type, preoperative VAS score of the back and leg, ODI, or IDH between the two groups (P > 0.05). The operation time of the UBE group was longer than that of the FD group, and the difference between the two groups was statistically significant (P < 0.05). However, the incision length and postoperative hospital stay of the UBE group were better than those of the FD group, and the differences between the two groups were statistically significant (P < 0.05). There was one case of cerebrospinal fluid leakage in the UBE group, with a complication rate of 3.33%, and one case of intervertebral space infection in the FD group, with a complication rate of 5.00%, with no statistically significant difference between the two groups (P > 0.05). The back VAS score and ODI improved in the two groups at 3 months and 1 year postoperatively, and the differences between the two groups were statistically significant (P < 0.05). Leg VAS in both groups was significantly improved at 3 days, 3 months, and 1 year postoperatively, but there was no statistical significance between the two groups (P > 0.05). The excellent and good rate in the UBE group (93.33%) was better than that in the FD group (80.00%), but there was no statistical significance between the two groups (P > 0.05). The imaging results showed that SLPR, FPR, and IDH 3 months and 1 year postoperatively were significantly better than those in the FD group, and the difference between the two groups was statistically significant (P < 0.05). Conclusions UBE and FD can relieve nerve compression and improve leg pain. However, UBE has shorter hospital stays in the case of small incisions and can minimize soft tissue stripping in the lower back, preserve bone tissue, and reduce lower back pain. In the short-term follow-up one year postoperatively, UBE improved low back pain and dysfunction more effectively, and the satisfaction of patients was higher than that of the FD group.

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Unilateral Biportal Percutaneous Transforaminal Endoscopic Lumbar Foraminal Decompression and Discectomy: A Technical Note

Cited by 4 publications

References 1 publication

A case report: Unilateral biportal endoscopic revision for adjacent segmental disease: Case presentations and literature review

A case report: Unilateral biportal endoscopic revision for adjacent segmental disease: Case presentations and literature review

The Impact of Preoperative Adaptive Training on Postoperative Outcomes in Lumbar Spine Fusion Surgery for Lumbar Disc Herniation: A Retrospective Analysis

Clinical efficacy of unilateral biportal endoscopy in the treatment of lumbar disc herniation

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