Contralateral inclinatory approach for decompression of the lateral recess and same-level foraminal lesions using unilateral biportal endoscopy: A technical report

Tian, Dan; Zhu, Bin; Li, Jianjun; Chen, Lei; Sun, Yisong; Zhong, Huazhang; Jing, Juehua

doi:10.3389/fsurg.2022.959390

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…However, UBED technique is not limited to the interlaminar approach, it can personalize surgical incisions and approaches based on the type of intervertebral disc herniation and location of nerve root compression, especially in cases of far-lateral lumbar disc herniation [41] , lateral recess stenosis and same-level foraminal stenosis [42] .…”

Section: Discussionmentioning

confidence: 99%

Is unilateral biportal endoscopic discectomy superior to percutaneous interlaminar endoscopic discectomy in the treatment of L5/S1 disc herniation? A retrospective study

YIN,

MA,

GAO

et al. 2024

Preprint

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Purpose To compare the clinical outcomes of unilateral biportal endoscopic discectomy (UBED) and percutaneous interlaminar endoscopic discectomy (PIED) for treating L5/S1 disc herniation. Methods Patients with L5/S1 disc herniation treated with UBED (n = 46) and PIED (n = 50) in our hospital during the same period were retrospectively reviewed. Total blood loss (TBL), operation time, hospital stay, complications, total hospitalization costs, clinical efficacy and modified MacNab criteria were collected and evaluated. Percentage of facet joint preservation measured on axial CT scans obtained pre-operation and post-operation. Results The mean follow-up period was 14.07 ± 3.50 months in UBED group, and 14.52 ± 5.37 months in PIED group. The total blood loss and hospitalization cost was more in the UBED Group. The operative time and hospital stay time in the UBED Group was similar with that in PIED Group. The postoperative VAS back, leg scores and ODI score were significantly improved compared with the preoperative scores in both two groups. There was no significant difference in VAS back and leg scores between two groups at 1-day post-operation and final follow-up period. All patients of two groups had similar ODI scores at final follow-up period. The percentage of facet joint preservation is 96.56 ± 9.11% in UBED group, which is significantly less than in PIED group with 99.22 ± 1.52%. One patient in both groups showed postoperative hematoma. A dural tear occurred in UBED group and a never root injury occurred in PIED group. There was no significant difference in patient satisfaction rates between two groups. Conclusion UBED indicates similar clinical effect compared with PIED for treating L5/S1 disc herniation, and there was no significant increase in surgical time or hospital stay. However, more facet joint damage, total blood loss and hospitalization cost may be the disadvantages of UBED technique and need to be taken seriously.

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Section: Discussionmentioning

confidence: 99%

Is unilateral biportal endoscopic discectomy superior to percutaneous interlaminar endoscopic discectomy in the treatment of L5/S1 disc herniation? A retrospective study

YIN,

MA,

GAO

et al. 2024

Preprint

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“…The UBE technique has been recently introduced with different applications, including decompression and interbody fusion (11,(21)(22)(23)(24)(25)(26)(27)(28)(29). It is based on using two independent portals (viewing and working) requiring two small incisions.…”

Section: Discussionmentioning

confidence: 99%

A single-arm retrospective study of the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion for lumbar spinal stenosis

et al. 2023

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ObjectiveThe purpose of this study was to investigate the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) for lumbar spinal stenosis (LSS).MethodsPatients who underwent UBE-TLIF due to single-segment LSS between August 2019 and July 2021 were retrospectively included in the study. Clinical outcomes evaluated include operative time, estimated blood loss (including postoperative drainage), time to ambulation, postoperative hospital stay, complications, visual analog scale (VAS) scores of low back pain and leg pain, Japanese Orthopaedic Association (JOA) score, Oswestry disability index (ODI), and modified Macnab criteria. Interbody bony fusion at the index level was assessed using Bridwell grading criteria.ResultsA total of 73 patients (29 males and 44 females) were enrolled in this study. All surgeries were successfully performed without intraoperative conversion to open surgery. Magnetic resonance imaging (MRI) revealed optimal direct neural decompression after UBE-TLIF. The mean operative time was 150.89 ± 15.58 min. The mean estimated blood loss was 126.03 ± 17.85 ml (postoperative drainage was 34.84 ± 8.31 ml). Time to ambulation was 2.0 ± 0.75 days after the procedure. Postoperatively, the mean hospital stay was 5.96 ± 1.38 days. VAS scores of low back pain and leg pain, JOA, and ODI were significantly improved postoperatively compared with those before the operation, and differences were statistically significant (P < 0.05). Excellent and good outcomes were reported by 87.67% of patients according to the modified Macnab criteria at the final follow-up. A total of nine perioperative complications occurred, with an incidence of 12.33%. X-ray or computerized tomography (CT) 6 months after the procedure showed that 37 cases (50.68%) presented with segmental fusion, 30 cases (41.10%) showed incomplete fusion, and 6 cases (8.22%) showed no signs of fusion. However, bony fusion was achieved in all cases at the final follow-up.ConclusionsUBE-TLIF for LSS has the advantages of less surgical invasiveness and fast postoperative recovery.

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Contralateral Sublaminar Approach in Lumbar Spine With Unilateral Biportal Endoscopy

de Oliveira,

Park

2024

J Minim Invasive Spine Surg Tech

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Unilateral biportal endoscopy (UBE) can be used to treat common lumbar pathologies, such as synovial facet cysts, foraminal disc herniations, and foraminal stenosis via a contralateral sublaminar approach. Due to the ultra-minimally invasive technique, UBE can reduce damage to anatomical structures, thereby reducing postoperative pain and allowing faster recovery. The patient is placed prone on a Wilson frame or bolsters. Fluoroscopy is used to identify the midline and medial pedicle line in the anterior-posterior projection. Spinal needles can aid to identifying portals’ trajectory in the lateral fluoroscopic projection. The procedure is performed via 2 separate portal incisions. The endoscope is introduced through the viewing portal and the surgical instruments through the working portal. Soft tissue dissector is used to create a working area over the spinous process-lamina junction. Bony shaving and drilling start at the target area and continue medially underneath the base of the spinous process until the midline and contralateral ligamentum flavum are identified. Contralateral ligamentum flavum is excised, exposing thecontralateral thecal sac, traversing nerve root, and lateral recess. The contralateral disc space, annulus, and superior articulating process are then identified and the offending pathology can be addressed under direct visualization. Meticulous hemostasis and close attention to outflow should be maintained to reduce the risk of complications. The steps of this procedure closely resemble those of traditional microscopic “over-the-top” techniques, including the surgical instruments used through the working portal. In this video, authors present the surgical technique of the contralateral sublaminar approach in the lumbar spine with UBE.

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Contralateral inclinatory approach for decompression of the lateral recess and same-level foraminal lesions using unilateral biportal endoscopy: A technical report

Cited by 3 publications

References 27 publications

Is unilateral biportal endoscopic discectomy superior to percutaneous interlaminar endoscopic discectomy in the treatment of L5/S1 disc herniation? A retrospective study

Is unilateral biportal endoscopic discectomy superior to percutaneous interlaminar endoscopic discectomy in the treatment of L5/S1 disc herniation? A retrospective study

A single-arm retrospective study of the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion for lumbar spinal stenosis

Contralateral Sublaminar Approach in Lumbar Spine With Unilateral Biportal Endoscopy

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