Advantages of 12° Endoscope in Unilateral Biportal Endoscopic Surgery for Lumbar Disc Herniation.

IF 1.7 Q2 SURGERY

International Journal of Spine Surgery Pub Date : 2025-10-06 DOI:10.14444/8771

Wenbo Wu, Yanqiu Xie, Yinkai Xue, Min Cui, Xianlin Zeng, Yukun Zhang, Cao Yang, Yongchao Wu

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引用次数: 0

Abstract

Objective: This study introduces the application of a 12° endoscope in unilateral biportal endoscopic (UBE) decompression surgery for lumbar disc herniation and discusses its advantages in UBE procedures.

Methods: From December 2019 to December 2020, 75 patients (33 men and 42 women) were treated with UBE decompression using a 12° endoscope. Patient ages ranged from 26 to 78 years (mean 53.2). Pre- and postoperative visual analog scale (VAS) scores for low back and leg pain were recorded. Surgical outcomes were evaluated using MacNab criteria, with operative time and complications documented.

Results: The 12° endoscope demonstrated superior maneuverability with a distortion-free visual field. Compared with 30° endoscopes, it showed better applicability within the anatomical working triangle while providing broader visualization than 0° endoscopes. This enabled effective decompression of the superior articular process medial edge, nerve root canal, and lateral recess. Low back pain VAS scores decreased from 7.3 ± 1.3 to 1.9 ± 1.2 (P < 0.001), while leg pain scores improved from 8.1 ± 1.8 to 1.6 ± 1.0 (P < 0.001). At the 12-month follow-up, MacNab criteria outcomes were excellent in 65.3%, good in 25.3%, and unsatisfactory in 9.3% of cases (χ ² test, P = 0.002).

Conclusion: The 12° endoscope demonstrates clinical value as a feasible, safe, and effective option for UBE surgery in lumbar disc herniation treatment.

Clinical relevance: Key clinical advantages of the 12° endoscope include direct visualization of key anatomical structures, minimized bone resection (particularly at the medial spinous process base), and a reduction in instrument crowding. These technical benefits contribute to effective decompression, improved patient outcomes (as measured by VAS and MacNab criteria), and potentially a shorter learning curve for surgeons adopting the UBE technique.

Level of evidence: 3:

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12°内窥镜在单侧双门静脉内窥镜治疗腰椎间盘突出症中的优势。

目的：介绍12°内窥镜在单侧双门静脉内窥镜（UBE）减压术治疗腰椎间盘突出症中的应用，并探讨其在UBE手术中的优势。方法：2019年12月至2020年12月，75例患者（男33例，女42例）在12°内窥镜下行UBE减压术。患者年龄26 ~ 78岁（平均53.2岁）。记录术前和术后腰痛和腿部疼痛的视觉模拟评分（VAS）。采用MacNab标准评估手术结果，记录手术时间和并发症。结果：12°内窥镜具有良好的可操作性和无畸变视野。与30°内窥镜相比，它在解剖工作三角形内具有更好的适用性，同时比0°内窥镜提供更广泛的可视化。这样可以有效地减压上关节突内侧缘、神经根管和外侧隐窝。腰痛VAS评分由7.3±1.3分降至1.9±1.2分（P < 0.001），腿痛评分由8.1±1.8分降至1.6±1.0分（P < 0.001）。随访12个月时，65.3%的MacNab标准预后为优，25.3%为良，9.3%为不满意（χ 2检验，P = 0.002）。结论：12°内窥镜作为治疗腰椎间盘突出症的一种可行、安全、有效的选择具有临床价值。临床意义：12°内窥镜的主要临床优势包括关键解剖结构的直接可视化，最大限度地减少骨切除（特别是在内侧棘突基部），以及减少器械拥挤。这些技术优势有助于有效减压，改善患者预后（根据VAS和MacNab标准衡量），并可能缩短采用UBE技术的外科医生的学习曲线。证据等级：3；

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来源期刊

International Journal of Spine Surgery Medicine-Surgery

CiteScore

3.10

自引率

0.00%

发文量

162

期刊介绍： The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.