Skip to main content

Unilateral Biportal Endoscopy for Non-migrated Lumbar Disc Herniation

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

Abstract

Surgical treatment for lumbar disc herniation has been gradually shifting from open microsurgery to endoscopic spine surgery. In the early period of endoscopic spinal surgery, there were some limitations; however, recently biportal endoscopic surgery has been suggested as an alternative surgical method for treating degenerative lumbar pathologies. It constitutes a sufficient surgical outcome and clinical option in various lumbar disc diseases. This chapter introduces and describes unilateral biportal endoscopic discectomy for non-migrated lumbar disc herniations. Some cases are presented in the chapter as an example.

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

Access this chapter

eBook
USD 16.99
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

AP:

Anteroposterior

LDH:

Lumbar disc herniation

LM:

Lumbar microdiscectomy

MISS:

Minimally invasive spine surgery

MRI:

Magnetic resonance imaging

PELD:

Percutaneous endoscopic lumbar discectomy

RF:

Radiofrequency

UBE:

Unilateral biportal endoscopy

References

  1. Seung-Kook K, Sang-Soo K, Young-Ho H, Seung-Woo P, Su-Chan L. Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis: research article. J Orthop Surg Res. 2018;13:22.

    Article  Google Scholar 

  2. Wu CY, Jou IM, Yang WS, Yang CC, Chao LY, Huang YH. Significance of the mass-compression effect of postlaminectomy/laminotomy fibrosis on histological changes on the dura mater and nerve root of the cauda equina: an experimental study in rats. J Orthop Sci. 2014;19:798–808.

    Article  PubMed  Google Scholar 

  3. He J, Xiao S, Wu Z, Yuan Z. Microendoscopic discectomy versus open discectomy for lumbar disc herniation: a meta-analysis. Eur Spine J. 2016;25:1373–81.

    Article  PubMed  Google Scholar 

  4. Podichetty VK, Spears J, Isaacs RE, Booher J, Biscup RS. Complications associated with minimally invasive decompression for lumbar spinal stenosis. J Spinal Disord Tech. 2006;19(3):161–6.

    Article  PubMed  Google Scholar 

  5. Adams MA, Hutton WC. The mechanical function of the lumbar apophyseal joints. Spine. 1983;8(3):327–30.

    Article  CAS  PubMed  Google Scholar 

  6. Adams MA, Hutton WC, Stott JR. The resistance to flexion of the lumbar intervertebral joint. Spine. 1980;5(3):245–53.

    Article  CAS  PubMed  Google Scholar 

  7. Cusick JF, Yoganandan N, Pintar FA, Reinartz JM. Biomechanics of sequential posterior lumbar surgical alterations. J Neurosurg. 1992;76(5):805–11.

    Article  CAS  PubMed  Google Scholar 

  8. Yeung AT. The evolution and advancement of endoscopic foraminal surgery: one surgeon’s experience incorporating adjunctive technologies. SAS J. 2007;1(3):108–17.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ahn Y. Percutaneous endoscopic decompression for lumbar spinal stenosis. Expert Rev Med Devices. 2014;11(6):605–16.

    Article  CAS  PubMed  Google Scholar 

  10. 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(3):431–7.

    Article  PubMed  Google Scholar 

  11. Lee SH, Kang BU, Ahn Y, et al. Operative failure of percutaneous endoscopic lumbar discectomy: a radiologic analysis of 55 cases. Spine. 2006;31(10):E285–90.

    Article  PubMed  Google Scholar 

  12. Jin Hwa E, Sang Kyu S, Ketan D, Alfonso G. Unilateral biportal endoscopic decompression for lumbar spinal stenosis. In: Kim DH, Choi G, Lee S-H, Fessler RG, editors. Endoscopic spine surgery. 2nd ed. Thieme Medical Publishers: New York; 2018. p. 75–80.

    Google Scholar 

  13. Komp M, Hahn P, Oezdemir S, et al. Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study. Pain Physician. 2015;18(1):61–70.

    Article  PubMed  Google Scholar 

  14. Hwa EJ, Hwa HD, Son SK, Park CK. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016;24(4):602–7.

    Article  Google Scholar 

  15. De Antoni DJ, Claro ML, Poehling GG, Hughes SS. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications. Arthroscopy. 1996;12(3):330–4.

    Article  PubMed  Google Scholar 

  16. Costa F, Sassi M, Cardia A, et al. Degenerative lumbar spinal stenosis: analysis of results in a series of 374 patients treated with unilateral laminotomy for bilateral microdecompression. J Neurosurg Spine. 2007;7(6):579–86.

    Article  PubMed  Google Scholar 

  17. Minamide A, Yoshida M, Yamada H, et al. Endoscope-assisted spinal decompression surgery for lumbar spinal stenosis. J Neurosurg Spine. 2013;19(6):664–71.

    Article  PubMed  Google Scholar 

  18. Dae-Jung C, Chang-Myong C, Je-Tea J, Sang-Jin L, Yong-Sang K. Clinical study learning curve associated with complications in biportal endoscopic spinal surgery: challenges and strategies. Asian Spine J. 2016;10(4):624–9.

    Article  Google Scholar 

  19. Choi CM, Chung JT, Lee SJ, Choi DJ. How I do it? Biportal endoscopic spinal surgery (BESS) for treatment of lumbar spinal stenosis. Acta Neurochir. 2016;158:459–63.

    Article  PubMed  Google Scholar 

  20. Dong Hwa H, Jin Hwa E, Sang KS. Percutaneous unilateral biportal endoscopic diskectomy and decompression for lumbar degenerative disease. In: Daniel HK, Gun C, Sang-Ho L, Richard GF, editors. Endoscopic spine surgery. 2nd ed. New York: Thieme Medical Publishers; 2018. p. 81–7.

    Google Scholar 

  21. Garg B, Nagraja UB, Jayaswal A. Microendoscopic versus open discectomy for lumbar disc herniation: a prospective randomised study. J Orthop Surg. 2011;19(1):30–4.

    Article  Google Scholar 

  22. Chang-Myong C. Biportal endoscopic spine surgery (BESS): considering merits and pitfalls review of techniques on full-endoscopic spine surgery. J Spine Surg. 2020;6(2):457–65.

    Article  Google Scholar 

  23. Hayati A. Bölüm 47: Unilateral biportal endoskopik lomber disk ve spinal stenoz cerrahisi. In: Hüseyin Yener E, Onur Y, Ertuğrul Ş, editors. Omurga Cerrahisinde Yeni Yaklaşımlar ve Minimal İnvaziv Omurga Cerrahisi. Ankara: Akademisyen Kitabevi; 2021. p. 379–93.

    Google Scholar 

  24. Gibson JN, Cowie JG, Iprenburg M. Transforaminal endoscopic spinal surgery: the future ‘gold standard’ for discectomy? A review. Surgeon. 2012;10:290–6.

    Article  PubMed  Google Scholar 

  25. Lee DY, Shim CS, Ahn Y, et al. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation. J Korean Neurosurg Soc. 2009;46:515–21.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ruetten S, Komp M, Merk H, et al. Recurrent lumbar disc herniation after conventional discectomy: a prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision. J Spinal Disord Tech. 2009;22:122–9.

    Article  PubMed  Google Scholar 

  27. Kim HS, Raorane HD, Wu PH, et al. Incidental durotomy during endoscopic stenosis lumbar decompression: incidence, classification, and proposed management strategies. World Neurosurg. 2020. pii: S1878-8750(20)30260-6.

    Google Scholar 

  28. Choi G, Kang HY, Modi HN, et al. Risk of developing seizure after percutaneous endoscopic lumbar discectomy. J Spinal Disord Tech. 2011;24(2):83–92.

    Article  PubMed  Google Scholar 

  29. Joh JY, Choi G, Kong BJ, Park HS, Lee SH, Chang SH. Comparative study of neck pain in relation to increase of cervical epidural pressure during percutaneous endoscopic lumbar discectomy. Spine. 2009;34(19):2033–8.

    Article  PubMed  Google Scholar 

  30. Parpaley Y, Urbach H, Kovacs A, et al. Pseudohypoxic brain swelling (postoperative intracranial hypotension-associated venous congestion) after spinal surgery: report of 2 cases. Neurosurgery. 2011;68:E277–83.

    Article  PubMed  Google Scholar 

  31. Kim HS, Sharma SB, Wu PH, et al. Complications and limitations of endoscopic spine surgery and percutaneous instrumentation. Indian Spine J. 2020;3:78–85.

    Article  Google Scholar 

  32. Pang HW, Hyeun-Sung K, Il-Tae J. A narrative review of development of full-endoscopic lumbar spine surgery, review article. Neurospine. 2020;17(Suppl 1):S20–33.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cigdem Mumcu .

Editor information

Editors and Affiliations

Electronic Supplementary Materials

Preparing skin portals (MP4 12125 kb)

Case 1 intraoperative video (MP4 8534 kb)

Case 2 intraoperative video (MP4 9008 kb)

Case 3 intraoperative video (MP4 10675 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

Mumcu, C. (2022). Unilateral Biportal Endoscopy for Non-migrated Lumbar Disc Herniation. 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_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-14736-4_13

  • 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