C-arm Free Unilateral Biportal Endoscopic Discectomy: A Technical Note

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar disc herniation often necessitates surgical intervention after conservative treatments fail.
• Minimally invasive endoscopic discectomy techniques face challenges like steep learning curves and reliance on C-arm fluoroscopy.
• Reducing radiation exposure during spinal surgery is a significant clinical goal.

Observation:

• A novel unilateral biportal endoscopic (UBE) technique utilizing standard intraoperative navigation (O-arm) was employed for lumbar disc herniation.
• A 24-year-old male patient with severe L4/5 central disc herniation and neurological deficits underwent C-arm-free UBE discectomy.
• The procedure was guided by O-arm navigation, avoiding traditional C-arm fluoroscopy.

Findings:

• The C-arm-free UBE discectomy was technically successful, achieving excellent decompression of the thecal sac and L5 nerve roots.
• Postoperative imaging confirmed successful decompression.
• The patient experienced full recovery of motor and sensory function in both legs within one year.

Implications:

• This navigation-guided UBE technique offers a safe, accurate, and effective method for treating lumbar disc herniation.
• The approach significantly minimizes radiation exposure for both the patient and surgical staff.
• This technique represents a promising advancement in minimally invasive spinal surgery, potentially overcoming previous limitations.