Gopi Jipin, Mammu Sharafuddeen, Jayan Aarabhy, P Jamshad O, R Fijad N, Vk Vaisakh
Department of Orthopaedics, Malabar Medical College Kozhikode, Kerala, India.
Department of Orthopaedics, Government Medical College Kozhikode, Kerala, India.
J Orthop Case Rep. 2025 Jan;15(1):67-72. doi: 10.13107/jocr.2025.v15.i01.5128.
Endoscopic spine surgery (ESS) is a minimally invasive technique that allows for direct visualization of spinal pathologies and has become a safe and effective alternative to traditional open spine surgery. Conventionally performed in the prone position, biportal endoscopy can also be done in the lateral position to avoid prone-associated complications. To our knowledge, the use of unilateral biportal endoscopy (UBE) in the lateral position has not been previously reported.
We present the case of a 53-year-old male who experienced severe low back pain and right-sided radiculopathy due to a disc protrusion at the L4-L5 level. The patient was managed surgically using UBE in the lateral position once the conservative management was ineffective. This innovative approach aimed to minimize the complications associated with the prone position typically used in such procedures.
The successful management of L4-L5 intervertebral disc prolapse using UBE in the lateral position in this case demonstrates the potential of this technique as an effective and minimally invasive alternative to conventional surgical methods. This approach could offer a viable solution for treating degenerative spinal diseases while mitigating the steep learning curve associated with ESS. Further research and clinical studies are necessary to validate and optimize this technique.
内镜脊柱手术（ESS）是一种微创技术，可直接观察脊柱病变，已成为传统开放性脊柱手术的一种安全有效的替代方法。双门内镜检查通常在俯卧位进行，也可在侧卧位进行以避免与俯卧位相关的并发症。据我们所知，此前尚未报道过在侧卧位使用单侧双门内镜检查（UBE）的情况。
我们报告一例53岁男性患者，因L4-L5节段椎间盘突出出现严重腰痛和右侧神经根病。保守治疗无效后，患者采用侧卧位UBE进行手术治疗。这种创新方法旨在尽量减少此类手术通常采用的俯卧位相关并发症。
本病例中采用侧卧位UBE成功治疗L4-L5椎间盘突出，证明了该技术作为传统手术方法的有效微创替代方法的潜力。这种方法可为治疗退行性脊柱疾病提供可行的解决方案，同时减轻与ESS相关的陡峭学习曲线。需要进一步的研究和临床研究来验证和优化该技术。
