Unilateral biportal endoscopy via two different approaches for upper lumbar disc herniation: a technical note

Area of Science:

• Spinal Surgery
• Minimally Invasive Techniques
• Endoscopic Procedures

Background:

• Traditional surgical methods for upper lumbar disc herniation (ULDH) are associated with frequent complications.
• The unilateral biportal endoscopy (UBE) technique presents a potential alternative for ULDH treatment.

Purpose of the Study:

• To investigate the clinical efficacy and safety of the unilateral biportal endoscopy (UBE) technique in treating patients with upper lumbar disc herniation (ULDH).

Main Methods:

• A retrospective analysis of 28 patients with ULDH treated using the UBE technique between January 2020 and December 2021.
• Data collected included surgical parameters, postsurgical outcomes (drainage, hospital stay, complications), and clinical efficacy assessed via modified MacNab score, Oswestry disability index (ODI), and visual analogue scale (VAS) at multiple time points.

Main Results:

• The UBE technique demonstrated successful surgical outcomes with significantly reduced VAS scores and improved ODI post-surgery (P < 0.05).
• Excellent to good outcomes were achieved in 96.43% of patients at the final follow-up.
• Minor complications, such as transient numbness, were reported in two patients and resolved with conservative treatment.

Conclusions:

• The unilateral biportal endoscopy (UBE) technique is a reliable and effective method for treating upper lumbar disc herniation (ULDH).
• This minimally invasive approach allows for tailored surgical strategies (interlaminar or paraspinal) and does not require specialized instrumentation.
• The UBE technique shows significant potential for widespread clinical application in managing ULDH.