Unilateral Biportal Percutaneous Transforaminal Endoscopic Lumbar Foraminal Decompression and Discectomy: A Technical Note

Background and Introduction: Minimally invasive spine surgery (MISS) is a set of techniques and procedures that reduces the local tissue injury while achieving the same results through traditional open surgery. The techniques for the treatment of lumbar disc hemiation and degenerative canal stenosis have evolved from tubular discectomy to endoscopic discectomy. This helps in preserving spine function. Good clinical outcomes have been reported with the use of an endoscope for degenerative lumbar disc disease. Objective: In this video abstract, we present a case lumbar foraminal stenosis in an elderly man that was treated successfully using unilateral biportal endoscopic spine surgery. (UBESS). Surgical Technique: A 70-year-old man presented with progressive neurogenic claudication and left L4 numbness and paresthesias. His claudication distance was 200 m. His MRI Lumbosacral spine showed severe left L4-5 foraminal stenosis due to a disc prolapse. The patient underwent a left-sided unilateral biportal endoscopic transforaminal decompression and discectomy at L4-5 successfully. Postoperative period was uneventful and the patient had significant relief in his symptoms. Postoperative MRI Lumbosacral spine showed no muscle damage with adequate decompression at left L4-5 level. Results: The patient had an uneventful recovery. Conclusion: Biportal percutaneous transforaminal endoscopic discectomy/decompression is an ideal alternative to the uniportal endoscopic and minimal invasive microsurgery for foraminal and paracentral disc herniations and lateral recess and foraminal stenosis.