Biportal Endoscopic Spinal Surgery for Lumbar Spinal Stenosis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Biportal endoscopic spinal surgery (BESS) combines aspects of microscopic and conventional percutaneous endoscopic spinal surgery.
• It utilizes two independent portals for viewing and working, allowing greater instrument maneuverability and a panoramic view.
• This approach aims to overcome the limitations of traditional endoscopic and microscopic techniques, such as restricted working space and contralateral access difficulties.

Purpose of the Study:

• To evaluate the efficacy and benefits of Biportal endoscopic spinal surgery (BESS) as a minimally invasive surgical option.
• To compare BESS with conventional spinal surgery techniques regarding outcomes and complications.
• To highlight the advantages of BESS in treating various lumbar spinal conditions.

Main Methods:

• BESS employs two independent portals (viewing and working) for surgical access.
• The technique allows for free handling of endoscopic instruments, providing a panoramic view.
• It facilitates wider sublaminar and foraminal decompression compared to traditional methods.

Main Results:

• BESS demonstrates promising early clinical outcomes for conditions like lumbar spinal stenosis and spondylolisthesis.
• The procedure offers reduced dissection and muscle injury, preserving spinal stability.
• Key merits include decreased postoperative infection rates and a potentially reduced need for fusion surgery in specific cases.

Conclusions:

• Biportal endoscopic spinal surgery (BESS) is a viable minimally invasive alternative for lumbar spine decompression.
• The technique offers advantages such as improved visualization, wider decompression, and preservation of spinal stability.
• While early results are promising, potential complications similar to other spinal procedures should be considered.