Unilateral Biportal Endoscopic Discectomy via the Contralateral Sublaminar Approach for Lumbar Disc Herniation with Very High-Grade Migration: A Technical Note and Case Series.
Yong Jin Park, Man Kyu Park, Sang Kyu Son, Young San Ko
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引用次数: 0
Abstract
Background: Lumbar disc herniation (LDH) with very high-grade migration is difficult to manage surgically because of its anatomical complexity and the risk of incomplete decompression. The unilateral biportal endoscopic (UBE) contralateral sublaminar approach is a minimally invasive technique that may be an alternative option for managing these cases.
Methods: In this multicenter retrospective study, we analyzed the clinical data of 15 patients with LDH with very high-grade upward or downward migration of ruptured disc fragments removed via the UBE contralateral sublaminar approach between June 2022 and June 2024. Clinical outcomes were assessed using the visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and modified MacNab criteria. Radiological outcomes were evaluated on postoperative MR images and serial plain radiographs.
Results: The mean operation time was 45.3 minutes, and the average length of hospital stay was 4.1 days. The VAS scores for back and leg pain improved significantly, and the ODI scores were notably lower at the final follow-up. Postoperative MRI confirmed the complete removal of migrated disc fragments in all patients, with no segmental instability observed during the follow-up. The technique allows for effective decompression with minimal bone removal, thereby preserving adjacent structures.
Conclusions: This study revealed the feasibility and potential benefits of the UBE contralateral sublaminar approach for LDH with very high-grade migration of ruptured disc fragments. While initial outcomes are promising, further comparative studies with more patients are needed to validate its efficacy and safety.
期刊介绍：
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
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