Skip to main content
SpringerLink
Log in

Unilateral Biportal Endoscopy for Rostrally and Caudally Migrated Lumbar Disc Herniations

  • Chapter
  • First Online:
Unilateral Biportal Endoscopy of the Spine

  • 563 Accesses

Abstract

A migrated lumbar disc herniation can be classified according to different directions and extend patterns in high- or low-grade cranial or caudal, respectively. These migrated discs represent a challenge for the surgeon due to the complicated anatomy around the migrated disc fragment. Sometimes, extensive bone removal is needed for reaching the subligamentous sequestration through most conservative procedures.

Unilateral biportal endoscopy (UBE) represents a minimally invasive option for this type of lesion derived from the lumbar intervertebral disc. Different biportal endoscopic approaches will allow these injuries to be removed and, at the same time, reduce the collateral damage related to the surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

CT:

Computed tomography

EBL:

Estimated blood loss

HLD:

Herniated lumbar disc

IAP:

Inferior articular process

IELD:

Interlaminar endoscopic lumbar discectomy

MD:

Microdiscectomy

MRI:

Magnetic resonance imaging

PLL:

Posterior longitudinal ligament

RF:

Radiofrequency

SAP:

Superior articular process

TELD:

Transforaminal endoscopic lumbar discectomy

UBE:

Unilateral biportal endoscopy

ULBD:

Unilateral laminotomy for bilateral decompression

References

  1. Ebeling U, Reulen HJ. Are there typical localisations of lumbar disc herniations? A prospective study. Acta Neurochir (Wien). 1992;117:143–8.

    Article  CAS  PubMed  Google Scholar 

  2. Choi KC, Lee DC, Shim HK, Shin SH, Park CK. A strategy of percutaneous endoscopic lumbar discectomy for migrated disc herniation. World Neurosurg. 2017;99:259–66.

    Article  PubMed  Google Scholar 

  3. Oppenheim H, Krause F. Ueber Einklemmung bzw. Strangulation der Cauda equina. Dtsch Med Wochenschr. 1909;35:697–700.

    Article  Google Scholar 

  4. Goldthwait JE. The lumbosacral articulation: an explanation of many cases of lumbago, sciatica and paraplegia. N Engl J Med. 1911;164:365–72.

    Google Scholar 

  5. Middleton GS, Teacher JH. Injury of the spinal cord due to rupture of the intervertebral disc during muscular effort. Glasgow Med J. 1911;76:1–6.

    PubMed  PubMed Central  Google Scholar 

  6. Mixter WJ, Barr JS. Rupture of the intervertebral disc with involvement of the spinal canal. N Engl J Med. 1934;211:210–4.

    Article  Google Scholar 

  7. Yasargil MG. Microsurgical operation of herniated lumbar disc. In: Lumbar disc adult hydrocephalus, Advances in neurosurgery, vol. 4. Berlin: Springer; 1977. p. 81.

    Google Scholar 

  8. Caspar W. A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. In: Lumbar disc adult hydrocephalus, Advances in neurosurgery, vol. 4. Berlin: Springer; 1977. p. 74–80.

    Google Scholar 

  9. Williams RW. Microlumbar discectomy. A conservative surgical approach to the virgin herniated lumbar disc. Spine J. 1978;3:175–82.

    Article  CAS  Google Scholar 

  10. McCulloch JA, Young PH, editors. Essentials of spinal microsurgery. Philadelphia: Lippincott Raven; 1998.

    Google Scholar 

  11. Hijikata S. A method of percutaneous nuclear extraction. J Toden Hosp. 1975;5:39–42.

    Google Scholar 

  12. Kambin P, Sampson S. Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res. 1986;207:37–43.

    Article  Google Scholar 

  13. Schreiber A, Suezawa Y, Leu H. Does percutaneous nucleotomy with discoscopy replace conventional discectomy? Eight years of experience and results in treatment of herniated lumbar disc. Clin Orthop Relat Res. 1989;238:35–42.

    Article  Google Scholar 

  14. Kim SK, Kang SS, Hong YH, Park SW, Lee SC. Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis. J Orthop Surg Res. 2018;13:22.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Wei FL, Zhou CP, Zhu KL, et al. Comparison of different operative approaches for lumbar disc herniation: a network meta-analysis and systematic review. Pain Physician. 2021;24:E381–92.

    PubMed  Google Scholar 

  16. Kang T, Park SY, Park GW, Lee SH, Park JH, Suh SW. Biportal endoscopic discectomy for high-grade migrated lumbar disc herniation. J Neurosurg Spine. 2020:1–6. https://doi.org/10.3171/2020.2.SPINE191452.

  17. Fardon DF, Milette PC, Combined Task Forces of the North American Spine Society, American Society of Spine Radiology, American Society of Neuroradiology. Nomenclature and classification of lumbar disc pathology. Recommendations of the combined task forces of the North American Spine Society, American Society of Spine Radiology, and American Society of Neuroradiology. Spine (Phila Pa 1976). 2001;26(5):E93–E113.

    Article  CAS  PubMed  Google Scholar 

  18. Kim JY, Heo DH. Contralateral sublaminar approach for decompression of the combined lateral recess, foraminal, and extraforaminal lesions using biportal endoscopy: a technical report. Acta Neurochir (Wien). 2021;163:2783–7.

    Article  PubMed  Google Scholar 

  19. Heo DH, Lee N, Park CW, Kim HS, Chung HJ. Endoscopic unilateral laminotomy with bilateral discectomy using biportal endoscopic approach: technical report and preliminary clinical results. World Neurosurg. 2020;137:31–7.

    Article  PubMed  Google Scholar 

  20. Heo DH, Kim JS, Park CW, Quillo-Olvera J, Park CK. Contralateral sublaminar endoscopic approach for removal of lumbar juxtafacet cysts using percutaneous biportal endoscopic surgery: technical report and preliminary results. World Neurosurg. 2019;122:474–9.

    Article  PubMed  Google Scholar 

  21. Choi KC, Kim JS, Park CK. Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation. Pain Physician. 2016;19:E291–300.

    Article  PubMed  Google Scholar 

  22. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33:931–9.

    Article  PubMed  Google Scholar 

  23. Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976). 2002;27:722–31.

    Article  PubMed  Google Scholar 

  24. Lee S, Kim SK, Lee SH, et al. Percutaneous endoscopic lumbar discectomy for migrated disc herniation: classification of disc migration and surgical approaches. Eur Spine J. 2007;16:431–7.

    Article  PubMed  Google Scholar 

  25. Choi KC, Lee JH, Kim JS, Sabal LA, Lee S, Kim H, et al. Unsuccessful percutaneous endoscopic lumbar discectomy: a single-center experience of 10,228 cases. Neurosurgery. 2015;76:372–80.

    Article  PubMed  Google Scholar 

  26. Choi G, Lee SH, Lokhande P, Kong BJ, Shim CS, Jung B, et al. Percutaneous endoscopic approach for highly migrated intracanal disc herniations by foraminoplastic technique using rigid working channel endoscope. Spine (Phila Pa 1976). 2008;33:E508–15.

    Article  PubMed  Google Scholar 

  27. Choi KC, Shim HK, Hwang JS, et al. Comparison of surgical invasiveness between microdiscectomy and 3 different endoscopic discectomy techniques for lumbar disc herniation. World Neurosurg. 2018;116:e750–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Hospital H+ Querétaro, Spine Clinic, Querétaro, México

    Javier Quillo-Olvera, Diego Quillo-Olvera, Javier Quillo-Reséndiz & Michelle Barrera-Arreola

Authors
  1. Javier Quillo-Olvera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diego Quillo-Olvera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Javier Quillo-Reséndiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michelle Barrera-Arreola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Javier Quillo-Olvera .

Editor information

Editors and Affiliations

  1. The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Hospital H+ Querétaro, Spine Clinic, Querétaro, Mexico

    Javier Quillo-Olvera

  2. The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Hospital H+ Querétaro, Spine Clinic, Querétaro, Mexico

    Diego Quillo-Olvera

  3. The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Hospital H+ Querétaro, Spine Clinic, Querétaro, Mexico

    Javier Quillo-Reséndiz

  4. Spine Center, Schoen Klinik Muenchen Harlaching, Muenchen, Germany

    Michael Mayer

Electronic Supplementary Materials

Intraoperative video of the right-sided L5–S1 discectomy from Case 1. Cra cranial, cau caudal, med medial, lat lateral, Rt right (MP4 16098 kb)

Intraoperative video of the right-sided L4–L5 fragmentectomy from Case 2. Cra cranial, cau caudal, med medial, lat lateral, Rt right (MP4 16445 kb)

Intraoperative video of the right-sided L5–S1 sequestrectomy from Case 3. Cra cranial, cau caudal, med medial, lat lateral, Rt right, SAP superior articular process (MP4 16235 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Quillo-Olvera, J., Quillo-Olvera, D., Quillo-Reséndiz, J., Barrera-Arreola, M. (2022). Unilateral Biportal Endoscopy for Rostrally and Caudally Migrated Lumbar Disc Herniations. In: Quillo-Olvera, J., Quillo-Olvera, D., Quillo-Reséndiz, J., Mayer, M. (eds) Unilateral Biportal Endoscopy of the Spine. Springer, Cham. https://doi.org/10.1007/978-3-031-14736-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-14736-4_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-14735-7

  • Online ISBN: 978-3-031-14736-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation