Yu Alexander, Li Samuel Q, Ndjonko Laura, Frost Jamie, Berman Daniel, Park Hyun-Jin, Cho Samuel K
Icahn School of Medicine at Mount Sinai, Department of Orthopaedic Surgery, New York, NY.
Department of Orthopedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, South Korea.
Spine (Phila Pa 1976). 2025 Mar 19. doi: 10.1097/BRS.0000000000005335.
Narrative review.
To provide an overview of the evolution of biportal endoscopic spine surgery (BE) and its role in addressing specific challenges in minimally invasive spinal procedures, focusing on its technical features and clinical applications.
Minimally invasive spine surgery has gained momentum due to its ability to reduce tissue damage, postoperative pain, and recovery times compared to traditional open surgery. BE has emerged as an innovative technique, offering unique visualization and maneuverability that allow for addressing complex spinal pathologies with comparable outcomes to other minimally invasive techniques.
This review explores the development of BE, its advantages and disadvantages compared to traditional and full endoscopic spine surgery, and its application in various spinal conditions, based on current literature.
BE facilitates enhanced visualization and maneuverability through the use of two independent portals, which allow for precise decompression, discectomy, and fusion procedures with minimal muscle disruption. Studies suggest that BE is well-suited for specific cases requiring delicate tissue handling and complex anatomical access. Studies report reduced postoperative pain, shorter hospital stays, and faster recovery compared to traditional methods. While challenges such as longer operation times and learning curves exist, BE offers a valuable alternative to other minimally invasive techniques in procedures like lumbar laminectomy, foraminotomy, and interbody fusion.
Biportal endoscopic spine surgery represents an important addition to the arsenal of minimally invasive spine techniques. Its flexibility and adaptability make it a promising option for specific spinal pathologies, particularly in cases where other techniques may pose limitations. Future research should focus on refining surgical protocols, enhancing training frameworks, and expanding the application of BE to other spinal regions and complex conditions.
叙述性综述。
概述双门内镜脊柱手术（BE）的发展及其在应对微创脊柱手术中特定挑战方面的作用，重点关注其技术特点和临床应用。
与传统开放手术相比，微创脊柱手术因其能够减少组织损伤、术后疼痛和恢复时间而得到了广泛应用。BE作为一种创新技术应运而生，它具有独特的可视化和可操作性，能够处理复杂的脊柱病变，其治疗效果与其他微创技术相当。
本综述基于当前文献，探讨BE的发展、与传统及全内镜脊柱手术相比的优缺点，以及其在各种脊柱疾病中的应用。
BE通过使用两个独立的通道，实现了增强的可视化和可操作性，从而能够在对肌肉破坏最小的情况下，精确地进行减压、椎间盘切除术和融合手术。研究表明，BE非常适合需要精细组织操作和复杂解剖入路的特定病例。研究报告显示，与传统方法相比，BE术后疼痛减轻、住院时间缩短、恢复更快。虽然存在手术时间较长和学习曲线等挑战，但在腰椎椎板切除术、椎间孔切开术和椎间融合术等手术中，BE为其他微创技术提供了一种有价值的替代方案。
双门内镜脊柱手术是微创脊柱技术中的一项重要补充。其灵活性和适应性使其成为特定脊柱病变的一个有前景的选择，特别是在其他技术可能存在局限性的情况下。未来的研究应集中在完善手术方案、加强培训框架，以及将BE的应用扩展到其他脊柱区域和复杂病情。
