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Updated: Aug 15, 2026
The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
Unilateral Bi-portal Endoscopic Spinal Surgery for Lumbar Disk Herniation and Canal Stenosis: Technical Nuances and
Shashank Nahar1, Ketan Deshpande2, Vishal Kumar3
1Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Introduction:
Lumbar degenerative pathologies such as lumbar disk herniation (LDH) and lumbar canal stenosis (LCS) are among the most common causes of chronic low back and radicular pain and require surgery in patients with failed conservative management. The Unilateral Bi-portal Endoscopy (UBE) technique has emerged as a minimally invasive alternative to surgically treat these pathologies, offering reduced morbidity and faster recovery. This study evaluates the clinical outcomes and safety of UBE in patients with LDH and LCS based on a fellowship-based experience.
Materials And Methods:
A case series of eight patients with LCS and LDH operated on using the UBE technique during our spine endoscopy fellowship training at a high-volume spine center in the central part of India in October 2025. Intraoperative parameters (duration, complications) and postoperative outcomes (visual analog scale [VAS] for back and leg pain, hospital stay, complications) were recorded. Data were statistically summarized using mean and standard deviation.
Results:
The mean operative time for a single level was 41.6 ± 7.8 min. No intraoperative or postoperative complications occurred. Mean pre-operative VAS for back pain (BP) was 5.75 ± 1.17, and for lower limb pain (LL) was 7.00 ± 1.31. On post-operative day 1, mean BP reduced to 2.87 ± 0.60 and LL to 3.37 ± 0.92; by post-operative day 7, BP and LL further decreased to 1.37 ± 0.50 and 2.12 ± 1.13, respectively. All patients were discharged within 3 days and resumed daily activities within a week.
Conclusion:
Based on our fellowship experience, we believe that UBE is a safe, effective, and minimally invasive surgical option for managing LDH and canal stenosis. It offers significant pain relief, reduced blood loss, faster recovery, and excellent patient satisfaction. Furthermore, this minimally invasive spine technique has a less steep learning curve, and its use of low-cost instruments provides a valuable learning opportunity for spine surgeons who are already performing conventional open surgical approaches.