Surgical Treatment of Extraforaminal Gas-Containing Pseudocyst Compressing L5 Nerve Root by Using Unilateral Biportal Endoscopy

An, Jin-Woo; Lee, Chul Woo

doi:10.1016/j.wneu.2018.12.186

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…In recent years, there have been increasing reports of UBE surgery for lumbar disc herniation and lumbar spinal stenosis (5)(6)(7)(8). In addition, the UBE technique can be used for nerve decompression of burst fracture (17), excision of the perispinal cyst (18,19), clearance of epidural abscess (20), treatment of epidural lipomatosis (21), treatment of foraminal stenosis (8,22), lumbar interbody fusion (6), and revision surgery (23).…”

Section: Discussionmentioning

confidence: 99%

The Learning Curve of Unilateral Biportal Endoscopic (UBE) Spinal Surgery by CUSUM Analysis

et al. 2022

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ObjectiveTo assess the learning curve of the unilateral biportal endoscopic (UBE) technique for the treatment of single-level lumbar disc herniation by cumulative summation (CUSUM) method analysis.MethodsA retrospective analysis was conducted to assess 97 patients' general condition, operation time, complications, and curative effect of single segmental UBE surgery performed by a spinal surgeon in his early stage of this technique. The learning curve of operation time was studied using a CUSUM method, and the cut-off point of the learning curve was obtained.ResultsThe operation time was 30 – 241(97.9 ± 34.7) min. The visual analog scale score of lower limb pain decreased from 5.75 ± 0.81 before the operation to 0.39 ± 0.28 at the last follow-up (P < 0.05). The Oswestry disability index score decreased from 66.48 ± 4.43 before the operation to 14.57 ± 3.99 at the last follow-up (P < 0.05). The CUSUM assessment of operation time revealed the learning curve was the highest in 24 cases. In the learning stage (1–24 cases), the operation time was 120.3 ± 43.8 min. In the skilled stage (25–97 cases), the operation time was 90.5 ± 27.8 min.ConclusionsAbout 24 cases of single segmental UBE operation are needed to master the UBE technique.

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Section: Discussionmentioning

confidence: 99%

The Learning Curve of Unilateral Biportal Endoscopic (UBE) Spinal Surgery by CUSUM Analysis

et al. 2022

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“…The pathology of our mass is benign. So far, extradural masses treated with UBE have been mostly benign; a primary malignant tumor was not illustrated (14,15). This technique may be an alternative decompression method for patients with metastatic tumors who would be unable to tolerate radical surgery.…”

Section: Discussionmentioning

confidence: 99%

Complete removal of intraspinal extradural mass with unilateral biportal endoscopy

Wang

Zhao

et al. 2022

Front. Surg.

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IntroductionUnilateral biportal endoscopic (UBE) technique can easily decompress the bony spinal canal and accommodate all open surgical instruments under endoscopic guidance. However, indications and reports of this technique have been limited to degenerative and infectious diseases.MethodsWe used the UBE technique for the decompression and removal of extradural mass lesions in five patients. Under endoscopic guidance, a unilateral approach was used, and decompression and flavectomy were performed. After decompression, removal of the tumor was performed using various forceps. We evaluated the technical process of the procedure, the patient's pre- and postoperative symptoms, and operative radiology and pathologic results.ResultsPostoperative pain and disability improved clinically for all patients. Four patients were confirmed as having an epidural cyst and one patient was diagnosed with hemangioma. During follow-up, no recurrence was observed.ConclusionsWe successfully removed five extradural mass lesions using a biportal endoscopic posterior approach without complications. The biportal endoscopic approach may have advantages, such as minimizing trauma to the normal structures, magnified endoscopic view, and early recovery after the surgery. Biportal endoscopy may be used as an alternative surgical treatment for symptomatic intraspinal extradural benign lesions.

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“…One notable aspect of UBESS is the absence of postoperative infection, which is a relatively common occurrence in conventional lumbar spinal surgery [23]. The incidence of spine infection after spine surgery ranges from approximately 0.1% to 4.5%, [3] 2020 RCT Korea Dural tear (2), hematoma (1) Kim et al [7] 2020 Retrospective Korea Hematoma (5), recurrence (16), dural tear (3) Choi et al [16] 2016 Retrospective Korea Dural tear (2), nerve root injury (1), incomplete decompression (1) Eum et al [25] 2016 Retrospective Korea Postoperative headache (3), dural tear (2), transient leg numbness (2), hematoma(1) Czigléczki et al [29] 2020 Retrospective Hungary Postoperative headache (3), dural tear (2), incomplete decompression (1) Li et al [31] 2022 Retrospective China Dural tear (1), transient paresthesia (1) Jung and Kim [32] 2022 Retrospective Korea Transient motor weakness (1) Zhu et al [33] 2022 Technical note China Transient paresthesia (1) An and Lee [34] 2019 Technical note Korea Operation site pain and numbness (1) Lin et al [35] 2019 Retrospective China Dural tear (1) Kim and Park [36] 2020 Retrospective Korea Dural tear (2), root injury (3), infection (2) Kim et al [37] 2020 Retrospective Korea Dural tear (3), hematoma (1) Kim et al [38] 2019 Retrospective Korea Transient paresthesia (5) Kang et al [39] 2019 Retrospective Korea Dural tear (1) Kang et al [40] 2020 Retrospective Japan Dural tear (2) Kim and Choi [41] 2018 Retrospective Korea Dural tear (2), hematoma (1) Hong et al [42] 2020 Retrospective Korea Dural tear (2) Heo et al [43] 2019 Retrospective Korea Dural tear (1), hematoma (1) Heo et al [44] 2018 Prospective Korea Dural tear (1), hematoma (1) Pao et al [45] 2020 Retrospective China (Taiwan) Dural tear (4), transient paresthesia (1), hematoma (1), incomplete decompression (1) Song and Lee [46] 2020 Technical note Korea Dural tear (1) Fishchenko et al [47] 2020 Retrospective Ukraine Dural tear (4) Ahn et al [48] 2018 Retrospective Korea Dural tear (1) Kim et al [49] 2018 Retrospective Korea Incomplete decompression (3) Eun et ...…”

Section: Infectionmentioning

confidence: 99%

Overview and Prevention of Complications During Biportal Endoscopic Lumbar Spine Surgery

Lee,

Shin,

et al. 2023

J Minim Invasive Spine Surg Tech

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Unilateral biportal endoscopic spine surgery (UBESS) is a minimally invasive surgical technique that has gained popularity for its potential benefits in various spinal lesions. It involves 2 small incisions, providing wide and clear endoscopic visualization, and causes less soft tissue damage than open surgery. UBESS offers flexibility and versatility in approaching different spinal disorders, including decompression of the spinal cord and root in the cervical or thoracic spine, as well as lumbar discectomy and spinal stenosis. One of the strengths of UBESS is its similarity to microscopic techniques, allowing for 2-handed endoscopic surgery. This familiarity makes it easier for surgeons to adopt endoscopic techniques and overcome the learning curve associated with spine endoscopy. However, some potential complications are associated with biportal endoscopic spine surgery, including dural tear, epidural hematoma, infection, incomplete surgery, and neural injury. Although the overall incidence of these complications is relatively low, it is important for clinicians to be aware of them and understand preventive methods.

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Surgical Treatment of Extraforaminal Gas-Containing Pseudocyst Compressing L5 Nerve Root by Using Unilateral Biportal Endoscopy

Cited by 4 publications

References 27 publications

The Learning Curve of Unilateral Biportal Endoscopic (UBE) Spinal Surgery by CUSUM Analysis

The Learning Curve of Unilateral Biportal Endoscopic (UBE) Spinal Surgery by CUSUM Analysis

Complete removal of intraspinal extradural mass with unilateral biportal endoscopy

Overview and Prevention of Complications During Biportal Endoscopic Lumbar Spine Surgery

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