Percutaneous Biportal Endoscopic Decompression for Lumbar Central Stenosis and Foraminal Stenosis

  • Dong Hwa Heo
  • Choon-Keun Park


Percutaneous biportal endoscopic surgery was a minimally invasive approach and used two portals or two channels during operation. One portal was used for endoscopy, and the other portal was used for working channel. Spinal instruments were used through working portal. Two portals should be joined around working area such as lamina or foramen. For the prevention of muscle injury, two portals should be made through loose epi-periosteal plane and inter-fascicular area. Continuous irrigation system must be used for clearing of surgical field and bleeding control. Irrigation fluid was drained from endoscopic portal to working portal. Radiofrequency systems were necessary for muscle dissection and bleeding control. Unilateral laminotomy with bilateral decompression can be achieved using percutaneous biportal endoscopic approach for the treatment of lumbar central and lateral recess stenosis. Biportal endoscopic approach can perform complete neural decompression like open surgery. Also, paraspinal Wiltse approach was attempted for lumbar foraminal stenosis. Full decompression of foraminal lesion can be achieved by percutaneous biportal endoscopic approach. The authors can achieve full neural decompression using biportal endoscopic surgery like conventional open surgery. Short learning curve and familial surgical anatomy are other merits of biportal endoscopic surgery.


Lumbar Stenosis Decompression Endoscopy 

Supplementary material

Video 4.1


Video 4.2


Video 4.3


Video 4.4



  1. 1.
    De Antoni DJ, Claro ML, Poehling GG, Hughes SS. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications. Arthroscopy. 1996;12(3):330–4.CrossRefGoogle Scholar
  2. 2.
    Heo DH, Son SK, Eum JH, Park CK. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus. 2017;43(2):E8.CrossRefGoogle Scholar
  3. 3.
    Choi D, Choi C, Jung J, Lee S, Kim Y. Learning curve associated with complications in biportal endoscopic spinal surgery: challenges and strategies. Asian Spine J. 2016;10(4):624–9.CrossRefGoogle Scholar
  4. 4.
    Olszewski AD, Yaszemski MJ, White AA. The anatomy of the human lumbar ligamentum flavum. New observations and their surgical importance. Spine (Philadelphia, Pa 1976). 1996;21(20):2307–12.CrossRefGoogle Scholar
  5. 5.
    Choi G, Kang H, Modi HN, et al. Risk of developing seizure after percutaneous endoscopic lumbar discectomy. J Spinal Disord Tech. 2011;24(2):83–92.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Dong Hwa Heo
    • 1
  • Choon-Keun Park
    • 2
  1. 1.Department of Neurosurgery, Endoscopic Spine Surgery CenterNanoori Hospital GangnamSeoulSouth Korea
  2. 2.Department of NeurosurgeryThe Leon Wiltse Memorial HospitalSuwonSouth Korea

Personalised recommendations