title: Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results.
abstract: OBJECTIVE
  The use of conventional uniportal spinal endoscopic decompression surgery for lumbar spinal stenosis can be limited by technical difficulties and a restricted field of vision. The purpose of this study is to describe the technique for percutaneous biportal endoscopic decompression (PBED) for lumbar spinal stenosis and analysis of clinical postoperative results.
  
  
  METHODS
  The authors performed a unilateral laminotomy with bilateral foraminal decompression using a unilateral biportal endoscopic system in patients with single-level lumbar stenosis. The authors enrolled only patients who underwent follow-up for longer than 12 months after PBED. Fifty-eight patients were enrolled in this study. This approach was based on 2 portals: one portal was used for continuous irrigation and endoscopic viewing and the other portal was used to manipulate the instruments used in the decompression procedures. Clinical parameters such as the Oswestry Disability Index (ODI), Macnab criteria, and postoperative complications were analyzed.
  
  
  RESULTS
  Neural decompression was effectively performed in all enrolled patients. The mean ODI was significantly lower after PBED. Of 58 patients, 47 (81.0%) had a good or excellent result according to the Macnab criteria. Postoperative ODI and visual analog scale scores were significantly improved compared with preoperative values.
  
  
  CONCLUSIONS
  From a surgical point of view, percutaneous biportal endoscopy is very similar to microscopic spinal surgery, permitting good visualization of the contralateral sublaminar and medial foraminal areas. The authors suggest that the PBED, which is a minimally invasive procedure, is an alternative treatment option for degenerative lumbar stenosis.
authors.affiliation: Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon; and.
authors.forename: Jin
authors.initials: J
authors.lastname: Hwa Eum
authors.affiliation: Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon; and.
authors.forename: Dong
authors.initials: D
authors.lastname: Hwa Heo
authors.affiliation: Department of Neurosurgery, Spine Center, Gumi Kang-dong Hospital, Gumi, Korea.
authors.forename: Sang Kyu
authors.initials: SK
authors.lastname: Son
authors.affiliation: Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon; and.
authors.forename: Choon Keun
authors.initials: CK
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D004185:Disability Evaluation; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery*; D013130:Spinal Stenosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: ODI = Oswestry Disability Index; PBED = percutaneous biportal endoscopic decompression; VAS = visual analog scale; biportal endoscopy; endoscopic decompression; lumbar stenosis