Abstract
Background and Study Aims Endoscopic lumbar diskectomy through the interlaminar window is gaining recognition.
Most of the literature describes these endoscopic procedures using specialized uniportal
multichannel endoscopes. However, a single portal limits the motion of the instruments
and obscures visualization of the operating field. To overcome this limitation, we
propose a new technique that utilizes two portals to access the spinal canal. The
biportal endoscopic lumbar decompression (BELD) technique uses two portals to treat
difficult lumbar disk herniations and also lumbar spinal stenoses.
Patients and Methods Seventeen patients were treated with BELD for 11 lumbar disk herniations and 6 lumbar
spinal stenoses. Preoperative back and leg visual analog scale (VAS-B and VAS-L, respectively)
scores and the Oswestry Disability Index (ODI) were recorded and compared with corresponding
values on final follow-up.
Results There was an average follow-up of 14 months. For the disk herniation group, preoperative
VAS-L (7.8750 ± 1.24) and ODI (51.73 ± 18.57) was significantly different from follow-up
postoperative VAS-L (0.87 ± 0.64, p = 0.000) and ODI (9.37 ± 4.83, p = 0.001). For the stenosis group, preoperative VAS-B (6.17 ± 1.94), VAS-L(7.83 ± 1.47),
and ODI (63.27 ± 7.67) were significantly different from follow-up postoperative values
(2.5 ± 1.04, p = 0.022; 2.00 ± 1.67, p = 0.001; 24.00 ± 6.45, p = 0.000, respectively). One patient underwent revision microdiskectomy for incomplete
decompression.
Conclusions BELD can achieve a similar decompression effect as microdiskectomy and unilateral
laminotomy for bilateral decompression with a smaller incision than tubular diskectomy.
Keywords
spinal endoscopy - diskectomy - minimal invasive - biportal - BELD
