title: Biportal Endoscopic Lumbar Decompression for Lumbar Disk Herniation and Spinal Canal Stenosis: A Technical Note.
abstract: Background and Study AimsEndoscopic lumbar diskectomy through the interlaminar window is gaining recognition. Most of the literature describes these endoscopic procedures using specialized uniportal multichannel endoscopes. However, a single portal limits the motion of the instruments and obscures visualization of the operating field. To overcome this limitation, we propose a new technique that utilizes two portals to access the spinal canal. The biportal endoscopic lumbar decompression (BELD) technique uses two portals to treat difficult lumbar disk herniations and also lumbar spinal stenoses.Patients and MethodsSeventeen patients were treated with BELD for 11 lumbar disk herniations and 6 lumbar spinal stenoses. Preoperative back and leg visual analog scale (VAS-B and VAS-L, respectively) scores and the Oswestry Disability Index (ODI) were recorded and compared with corresponding values on final follow-up.ResultsThere was an average follow-up of 14 months. For the disk herniation group, preoperative VAS-L (7.8750 ± 1.24) and ODI (51.73 ± 18.57) was significantly different from follow-up postoperative VAS-L (0.87 ± 0.64,p= 0.000) and ODI (9.37 ± 4.83,p= 0.001). For the stenosis group, preoperative VAS-B (6.17 ± 1.94), VAS-L(7.83 ± 1.47), and ODI (63.27 ± 7.67) were significantly different from follow-up postoperative values (2.5 ± 1.04,p= 0.022; 2.00 ± 1.67,p= 0.001; 24.00 ± 6.45,p= 0.000, respectively). One patient underwent revision microdiskectomy for incomplete decompression.ConclusionsBELD can achieve a similar decompression effect as microdiskectomy and unilateral laminotomy for bilateral decompression with a smaller incision than tubular diskectomy.
authors.affiliation: Department of Orthopaedics, Spine Health Wooridul Hospital, Gangnam-gu, Seoul, the Republic of Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Eun
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Pohang, the Republic of Korea.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Eum
authors.affiliation: Department of Neurosurgery, Spine Health Wooridul Hospital, Seoul, the Republic of Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Spine, Spine Health Wooridul Hospital, Gangnam, Seoul, the Republic of Korea.
authors.forename: Luigi Andrew
authors.initials: LA
authors.lastname: Sabal
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D013130:Spinal Stenosis / Q000601:surgery*