Optimizing Revision Lumbar Surgery: The Unilateral Biportal Endoscopic Approach

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Revision lumbar surgery presents significant challenges including scar tissue, altered anatomy, and elevated complication risks.
• Conventional open revision techniques often lead to increased tissue damage and prolonged recovery periods.
• The Unilateral Biportal Endoscopic (UBE) technique provides enhanced visualization and maneuverability, potentially improving safety and outcomes in revision procedures.

Purpose of the Study:

• To assess the efficacy and safety of the Unilateral Biportal Endoscopic (UBE) technique for complex lumbar revision surgeries.
• To compare clinical outcomes, complications, and patient satisfaction between UBE and conventional revision methods.

Main Methods:

• A retrospective analysis of 10 patients undergoing revision lumbar surgery with the UBE technique (February 2022 - February 2024).
• Clinical outcomes were measured using the Visual Analog Scale (VAS) for pain and the Oswestry Disability Index (ODI).
• Patient satisfaction and complication rates were systematically evaluated.

Main Results:

• Significant postoperative reductions in leg pain (VAS 8.1 to 0.8) and back pain (VAS 7.5 to 1.7) were observed (p < 0.001).
• The Oswestry Disability Index (ODI) score improved substantially from 67.5 to 17.5 (p < 0.001).
• No major complications were reported, with 70% of patients achieving excellent satisfaction.

Conclusions:

• The Unilateral Biportal Endoscopic (UBE) technique is a safe and effective minimally invasive approach for complex lumbar revision surgery.
• UBE facilitates significant pain relief, functional recovery, and demonstrates a low complication profile.
• By preserving soft tissues and offering superior visualization, UBE presents a promising alternative to conventional revision techniques.