Percutaneous Biportal Endoscopic Surgery for Lumbar Degenerative Diseases

Abstract

Objective Percutaneous uniportal endoscopic surgery is comparable to conventional open surgery and maintains the surrounding structures, but it has restrictive indications and technical difficulties in sufficient decompression. Percutaneous biportal endoscopic surgery (PBES) can compensate the shortcomings and provide sufficient decompression safely. The purpose of this study is to introduce PBES technique and to report clinical outcome. Methods Seventeen consecutive patients who underwent PBES for spinal stenosis or disc herniation were enrolled for this study. The technique was based on two routes; endoscopic view portal and working portal. Clinical outcomes were assessed using visual analogue scale (VAS) and modified Macnab’s criteria. Results There were 7 female and 10 male patients whose age ranged from 33 to 80 years old (mean 53 years). A total of 10 patients underwent decompression and discectomy for herniated intervertebral disc (HIVD), and 7 patients underwent laminectomy and foraminotomy for lumbar spinal stenosis. The mean follow up period was 8.3 months (6-12 months). The mean VAS scores for back pain preoperatively and postoperatively at the 1 month and 6 month follow-ups were 6.6±1.8, 2.8±2.0, and 2.5±2.0, respectively. The mean VAS scores for leg pain preoperatively and at 1 month and 6 month follow-ups were 7.6±1.9, 1.7±1.3 and 1.8±1.1, respectively. The outcome of the procedure was excellent in 8 patients and good in 9 patients according to the modified Macnab’s criteria. Conclusion PBES can achieve effective decompression and show comparable results with conventional open surgery.

Keywords

• percutaneous biportal endoscopic surgery
• minimal invasive spinal surgery
• spinal stenosis
• lumbar disc herniation