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Updated: Apr 4, 2026
Author Spotlight: Scope of LE-ULBD as a Safe, Effective, and Minimally Invasive Approach to Treat Lumbar Spinal Stenosis
Published on: February 9, 2024
Unilateral biportal endoscopic lumbar hemivertebra resection with bilateral percutaneous fixation in a pediatric
Peng Zhang1, Zijie Sun1, Kun Li1
1Department of Orthopedics, The 904th Hospital of Joint Logistic Support Force of PLA, Wuxi, China.
Background:
Minimally invasive techniques are gaining interest in pediatric spinal deformity surgery. Unilateral biportal endoscopy (UBE) offers precise visualization with minimal tissue disruption. However, achieving sufficient biomechanical stability after a major osteotomy, such as hemivertebra (HV) resection, remains critical.
Methods:
A 7-year-old girl with progressive congenital scoliosis (CS) (segmental Cobb angle 32°) due to a left L4/L5 semi-segmented HV underwent complete HV resection via UBE. Using a fully percutaneous technique, the UBE portals were reused for ipsilateral pedicle screw insertion at L4 and L5. Two additional contralateral stab incisions enabled bilateral percutaneous screw placement, followed by rod insertion and compression.
Results:
The 210-minute procedure achieved a 56% segmental correction (32° to 14°), with estimated blood loss of 100 mL. At 6-month follow-up, correction was maintained (Cobb 14°) with evidence of radiographic fusion and no complications. The entire procedure required only four stab incisions (each 1-1.5 cm).
Conclusion:
UBE enables precise lumbar HV resection under direct visualization. When synergized with bilateral percutaneous short-segment fixation, it provides the mechanical integrity essential for maintaining correction. This combined protocol successfully marries minimal tissue disruption with surgical efficacy, offering a promising alternative within the minimally invasive armamentarium for pediatric spinal deformity.
