Department of Orthopedic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine; Orthopedics Research Institute of Zhejiang University; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province; Clinical Research Center of Motor System Disease of Zhejiang Province.
Zhejiang University School of Medicine.
J Vis Exp. 2023 Dec 15(202). doi: 10.3791/65497.
Unilateral biportal endoscopy (UBE) is a minimally invasive spinal surgery technique increasingly employed in treating degenerative lumbar diseases, such as lumbar disc herniation, lumbar spinal stenosis, and spondylolisthesis. In UBE, two independent yet interconnected surgical channels are established-one for the endoscope and the other for surgical instruments-providing a broad and clear surgical field of view. UBE offers several advantages over traditional open surgery, including reduced tissue damage, shorter hospital stays, and faster recovery times. Additionally, it combines the benefits of microscopic surgery and interlaminar endoscopy, enhancing flexibility, accuracy, and reliability during the procedure. The learning curve for UBE is shorter than that for transforaminal endoscopy, as the surgical processes closely resemble those of conventional open surgery. Despite its favorable clinical outcomes, such as reduced blood loss and shorter hospitalization, UBE carries potential complications, including epidural hematoma, dural injury, and compression of the outlet nerve root. To mitigate these risks, it is crucial to ensure appropriate patient selection, apply the correct surgical technique, and engage in careful postoperative monitoring. This article provides a detailed summary of the step-by-step surgical techniques used in UBE for treating lumbar disc herniation. It serves as a comprehensive guide to enhance practitioners' understanding of UBE. The presentation also underscores the importance of rigorous training and expertise to ensure optimal patient outcomes.
单侧双通道内镜技术(UBE)是一种微创脊柱手术技术,越来越多地用于治疗退行性腰椎疾病,如腰椎间盘突出症、腰椎管狭窄症和腰椎滑脱症。在 UBE 中,建立了两个独立但相互连通的手术通道——一个用于内镜,另一个用于手术器械——提供了广阔而清晰的手术视野。UBE 相较于传统的开放性手术具有多项优势,包括减少组织损伤、缩短住院时间和更快的康复时间。此外,它结合了显微镜手术和椎板间内镜的优点,在手术过程中提高了灵活性、准确性和可靠性。UBE 的学习曲线比经椎间孔内镜短,因为手术过程与传统的开放性手术非常相似。尽管 UBE 具有减少出血和缩短住院时间等有利的临床结果,但也存在潜在的并发症,包括硬膜外血肿、硬脊膜损伤和出口神经根受压。为了降低这些风险,确保适当的患者选择、应用正确的手术技术和进行仔细的术后监测至关重要。本文详细总结了 UBE 治疗腰椎间盘突出症的分步手术技术,为增强从业者对 UBE 的理解提供了全面的指导。同时强调了严格的培训和专业知识的重要性,以确保患者获得最佳的治疗效果。