Innovative combination of unilateral biportal endoscopic discectomy and interlaminar dynamic stabilization using the IntraSPINE device for huge lumbar disc herniation: technical note and preliminary report.

Abstract

Introduction: The unilateral biportal endoscopy (UBE) technique has demonstrated favorable outcomes in lumbar discectomy and decompressive laminectomy. IntraSPINE is an innovative interlaminar dynamic stabilization device providing a minimally-invasive alternative for the treatment of degenerative lumbar diseases.

Aim: The objective of this study was to describe the rationale, surgical technique, and preliminary results of an innovative approach involving integration of UBE discectomy and interlaminar stabilization using IntraSPINE for the treatment of huge lumbar disc herniation (LDH).

Materials and methods: We analyzed 5 consecutive patients with huge LDH who underwent UBE decompressive laminectomy and discectomy combined with IntraSPINE interlaminar dynamic stabilization at our hospital between May and August 2023. The IntraSPINE interlaminar spacer was implanted contralaterally to the symptomatic interlaminar space with the assistance of UBE. X-ray, computed tomography, and magnetic resonance imaging were used to evaluate the range of segmental movement, posterior disc height (PDH), and disc degeneration at the baseline, after surgery, and at the final follow-up. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI).

Result: The procedure was successfully completed in all patients. Postoperative radiological imaging showed an increase in PDH and no exacerbation of lumbar disc degeneration. The VAS and ODI scores recorded after surgery and at the final follow-up visit improved remarkably, as compared with the baseline values. No surgery-related complications were reported.

Conclusion: The combination of UBE and IntraSPINE technology demonstrated good short-term outcomes. The advantages of this hybrid approach include maintaining intervertebral height, preserving intervertebral disc structure, and minimal invasiveness.