Biportal Versus Uniportal Lumbar Decompression-Indications and Efficacy: A Review With Case Examples

Minimally invasive lumbar decompression surgery offers many advantages including reduced patient morbidity and quicker return to normal life. Endoscopic lumbar spine surgery, sometimes termed "ultra" minimally invasive, further pushes the envelope on reducing operative time, blood loss, and recovery time. Endoscopy offers the additional advantage to the surgeon of placing the surgeon's eye not 50 cm away through the lens of loupes or a microscope, but right at the spine pathology in high definition. Uniportal approach involves a single incision through which the endoscope and instruments are passed. Biportal approach involves two incisions, one for the endoscope and one for the instruments. In what follows we review the indications and efficacy of these procedures with case examples.