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Complications Associated with Unilateral Biportal Endoscopic Spine Surgery

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Unilateral Biportal Endoscopy of the Spine

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Abstract

Percutaneous endoscopic surgery is becoming one of the most common procedures for lumbar disc herniation, lumbar spinal stenosis, and also fusion surgeries. It is becoming more popular due to smaller incisions, less blood loss, and early discharge. This chapter covers the unilateral biportal endoscopy (UBE) technique and the complications associated. UBE has its unique advantage of leaving a minimal footprint making it the most advanced minimally invasive spine surgery at present. As the technique is becoming popular, characteristic side effects such as irrigation-related problems, incomplete decompression due to instrument constraint, and repetitive radiation exposure due to lack of three-dimensional orientation are being increasingly recognized. Additionally, insufficient disc removal, incidental dural tear, difficult endoscopic hemostasis, and a steep learning curve are also being identified and studied. Some of the complications are unique and so are the treatment for these complications. This chapter looks into the various complications of the unilateral biportal endoscopic technique and the management of such complications using a systematic review of the literature and draws conclusions about the various complications and their management. It is recommended to continue to watch out for future prospective studies with controlled treatment protocols and long-term follow-up periods (longer than 3 years) to elucidate the long-term prevalence and outcomes of these complications.

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Abbreviations

BESS:

Biportal endoscopic spinal surgery

CSF:

Cerebrospinal fluid

ICP:

Intracranial pressure

IDT:

Incidental dural tear

LC-CUSUM:

Learning curve cumulative summation test

LDH:

Lumbar disc herniation

LF:

Ligamentum flavum

PSEH:

Postoperative spinal epidural hematoma

UBE:

Unilateral biportal endoscopy

ULBD:

Unilateral laminotomy for bilateral decompression

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Author information

Author notes

  1. Dr. Rajeesh George and Dr. Pang Hung Wu contributed equally to this work as first authors.

Authors and Affiliations

  1. National University Health System, Juronghealth Campus, Department of Orthopaedic Surgery, Ng Teng Fong General Hospital, Singapore, Singapore

    Rajeesh George, Pang Hung Wu & Gamaliel Tan Yu Heng

Authors
  1. Rajeesh George
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  2. Pang Hung Wu
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  3. Gamaliel Tan Yu Heng
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Corresponding author

Correspondence to Pang Hung Wu .

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

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George, R., Wu, P.H., Heng, G.T.Y. (2022). Complications Associated with Unilateral Biportal Endoscopic Spine Surgery. 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_31

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  • DOI: https://doi.org/10.1007/978-3-031-14736-4_31

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  • Online ISBN: 978-3-031-14736-4

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