A Novel Biportal Full Endoscopy Technique for Lumbar Lateral Recess Stenosis: Technical Report

Full endoscopy spine surgery is one of the minimally invasive procedures for lumbar spine disease and is especially popular in East Asia. As for the interlaminar approach, lumbar recess stenosis can be manipulated through a uniportal bigger diameter working channel spinal endoscope or a smaller one, or a biportal arthroscope. Each kind of procedure has its advantages and shortcomings. Here, a novel experience in biportal interlaminar approach for lumbar recess stenosis is presented. A smaller uniportal spinal endoscope is adopted for biportal procedures rather than the arthroscope. Briefly, 2 spinal endoscope working tubes are placed onto the interlaminar window of the target segment. Both of the 2 working tubes can serve as either a viewing or working channel, which means that more flexible visual fields and instrument manipulation can be used during the procedures. Bigger surgical instruments can be used directly through one working tube, and the visual field can be provided by the spinal endoscope in the other working tube. Smaller surgical instruments can be used at the same time through the working channel of the endoscope. The 2 working tubes can change their roles according to the surgeon's needs. This paper will describe the surgical technique and perioperative management.