Utility of the scope retractor for adhesiolysis in unilateral biportal endoscopic lumbar surgery: illustrative cases
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Updated: Jun 24, 2026
Percutaneous Endoscopic Unilateral-Approach Bilateral Decompression for Lumbar Spinal Stenosis
Published on: February 9, 2024
Changik Lee1, Young-Jin Kim2, Jin-Sung Kim3
1Department of Neurosurgery, Gangnam GIE Hospital, Seoul.
Background:
During unilateral biportal endoscopic (UBE) lumbar surgery, adhesiolysis can be technically challenging compared with microscopic lumbar surgery because of the constraints imposed by single-handed manipulation. The authors evaluated the use of a scope retractor as an adjunctive tool to facilitate bimanual-like tissue handling.
Observations:
Two illustrative cases with severe epidural adhesions-one related to postoperative scarring and the other associated with chronic inflammation from a synovial cyst-were treated with the aid of a scope retractor, which was used either to secure adhesive tissue or as a dissecting instrument. Successful adhesiolysis and adequate neural decompression were achieved in both cases.
Lessons:
UBE surgery provides high-quality visualization that enhances differentiation between the dura mater and surrounding soft tissue. Incorporation of a scope retractor facilitates precise tissue handling by providing an effect analogous to bimanual manipulation, improving surgical outcomes in cases with severe epidural adhesions. https://thejns.org/doi/10.3171/CASE26223.
