Foraminal and extraforaminal lumbar disc herniations are common sources of pain and disability. Classic surgical treatments, such as open approach through Witsel technique, often involve resection of the superior articular process to decompress the foraminal space. Unilateral biportal endoscopy (UBE) has emerged as a minimally invasive alternative, providing enhanced visualization and precision while minimizing soft tissue damage. The extraforaminal approach using UBE offers a more effective solution for extraforaminal herniations, requiring less bone resection, reducing the risk of pars fracture and enhancing visualization. This article presents a comprehensive methodology for the extraforaminal approach, supported by an illustrated guide, surgical tips and highlights of UBE's advantages over traditional techniques.
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Foraminal and extraforaminal lumbar disc herniations are common sources of pain and disability. Classic surgical treatments, such as open approach through Witsel technique, often involve resection of the superior articular process to decompress the foraminal space. Unilateral biportal endoscopy (UBE) has emerged as a minimally invasive alternative, providing enhanced visualization and precision while minimizing soft tissue damage.
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Global Spine J
February 2025
Research & Development (R&D), Endospine SLU, Andorra la Vella, Andorra.
Study Design: Exploratory prospective observational cohort.
Objectives: Aim of this study was to evaluate clinical and radiologic outcome, and surgical efficiency of a novel universal delivery system that allows full-percutaneous extraforaminal, trans-Kambin lumbar interbody fusion with a large-footprint lumbar interbody cage using only fluoroscopic imaging and open-surgery instrumentation.
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[Lumbar Foraminal Stenosis: Diagnosis and Microsurgical Decompression].
No Shinkei Geka
January 2025
Department of Neurosurgery, Tokyo Teishin Hospital.
Lumbar foraminal stenosis is a common problem; however, correct diagnosis and appropriate surgical treatment are difficult. This article describes the author's techniques for imaging diagnosis using thin-slice magnetic resonance imaging(MRI) and the microsurgical technique of foraminal decompression through the intermuscular approach. Thin-slice MRI consists of 1-mm thickness continuous images of the lumbar spine using a T2-weighted-image-based sequence.
View Article and Find Full Text PDFEndoscopic Transforaminal Approach for Extraforaminal Lumbosacral (L5-S1) Synovial Cyst Resection: 2-Dimensional Operative Video.
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January 2025
Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Percutaneous paravertebral endoscopic decompression for the treatment of far-out syndrome involving the L5 nerve root: technical report and preliminary results.
BMC Musculoskelet Disord
January 2025
Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, P. R. China.
Objective: The aim of this study was to describe the technique of percutaneous paravertebral endoscopic decompression for the treatment of far-out syndrome and to analyze the early clinical results of this technique.
Methods: From April 2021 to June 2023, a retrospective study was conducted on patients with far-out syndrome who underwent percutaneous paravertebral endoscopic decompression at Hospital of Chengdu University of Traditional Chinese Medicine. The Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria were utilized for the assessment of leg pain, quality of life, and clinical efficacy, respectively.
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