Primer on unilateral biportal endoscopic spine surgery: technical overview for beginners.

IF 4.7 1区医学 Q1 CLINICAL NEUROLOGY

Spine Journal Pub Date : 2025-06-10 DOI:10.1016/j.spinee.2025.06.003

Erick R Kazarian, Jason I Yang, Gregory S Kazarian, Yong H Kim

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Abstract

Background context: Unilateral biportal endoscopic (UBE) spine surgery is a minimally invasive technique that offers the benefits of enhanced visualization and reduced tissue disruption compared to traditional open spine surgery.

Purpose: This review outlines the historical evolution, technical considerations, and adoption challenges of UBE, focusing on its use in lumbar spine procedures.

Study design/setting: Technique overview.

Methods: The biportal approach, characterized by separate working and visualization portals, facilitates the minimally invasive benefits of endoscopy while maintaining the tactile feedback of open surgery. Key elements, including portal placement, fluid management, instrumentation, and operative room setup, are discussed.

Results: The learning curve for UBE is steep yet manageable, with most surgeons achieving proficiency within 25 to 50 cases through cadaver labs, mentorship, and selective case strategies. Early adoption challenges, such as establishing viewing windows and managing complications, are addressed.

Conclusions: As its indications expand to thoracic and cervical pathologies, UBE promises to enhance patient outcomes by providing effective, minimally invasive surgical options for a broader range of spinal conditions.

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单侧双门静脉内窥镜脊柱手术入门：初学者技术概述。

背景：单侧双门静脉内窥镜（UBE）脊柱手术是一种微创技术，与传统的开放脊柱手术相比，它具有增强可视化和减少组织破坏的优点。目的：本综述概述了UBE的历史演变、技术考虑和采用挑战，重点是其在腰椎手术中的应用。方法：双门静脉入路，具有独立的工作门静脉和可视化门静脉的特点，在保持开放手术触觉反馈的同时，促进了内窥镜的微创优势。关键要素，包括门静脉放置，流体管理，器械，手术室设置，讨论。结果：UBE的学习曲线陡峭但易于管理，大多数外科医生通过尸体实验室，指导和选择性病例策略在25-50例中达到熟练程度。解决了早期采用的挑战，例如建立观察窗口和管理并发症。结论：随着其适应症扩展到胸部和颈部病变，UBE有望通过为更广泛的脊柱疾病提供有效的微创手术选择来提高患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Spine Journal 医学-临床神经学

CiteScore

8.20

自引率

6.70%

发文量

680

审稿时长

13.1 weeks

期刊介绍： The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.