Background Meningiomas are common intradural extramedullary spinal tumors, which arise from arachnoid cap cells in the leptomeninges surrounding the brain or spinal cord. Sensory and motor dysfunction as well as pain were the most common presenting symptoms. Surgical resection remains the primary treatment for spinal intradural extramedullary meningiomas. Traditionally, spinal meningiomas excision requires longer skin incision, bilateral subperiosteal muscle stripping, and total laminectomy. We report a new technique for the treatment of thoracic spinal intradural extramedullary meningioma, which involves the use of unilateral biportal endoscopy (UBE) technique to resect the tumor, and reviewed and analyzed relevant literature. Case presentation A 69-year-old female patient presented with back pain accompanied by slowly progressive lower limb paresis, and severe pain in the right lower limb. Magnetic resonance imaging suggests a thoracic spinal intradural extramedullary meningioma. She underwent meningioma resection using UBE technique with complete recovery at the follow-up examination 3 months after surgery. Conclusion This case confirmed the UBE technique can be a good choice for resection of spinal intradural extramedullary meningioma.

OBJECTIVE:We aimed to preliminarily explore the efficacy and safety of unilateral biportal endoscopy for the treatment of epidural cement leaks. We report a patient who underwent epidural cement leakage removal and achieved endoscopic spinal decompression. METHODS:A 67-year-old female patient underwent biportal endoscopic paraspinal decompression following percutaneous vertebroplasty for an osteoporotic fracture that resulted in neurologic impairment due to epidural cement leakage. A transforaminal biportal endoscopic surgery was performed to remove the leaked cement, and the left L1 and bilateral L2 nerves were decompressed. RESULTS:The patient's postoperative clinical course was uneventful. CONCLUSIONS:A paraspinal approach that avoids a posterior approach reduces the need to remove stabilizing facet bone, is truly minimally invasive and does not involve an instrumented fusion, maybe a helpful addition in the minimally invasive spine surgeon's armamentarium.

OBJECTIVE: To evaluate the preliminary outcomes and clinical efficacy of a novel posterior biportal endoscopic technique in the treatment of central cervical disc herniation (CCDH). METHODS: A total of 11 patients with symptomatic CCDH who met the inclusion criteria underwent posterior biportal endoscopic discectomy between December 2021 and May 2023. The surgical procedure involved flavectomy, foraminotomy, pediculoplasty, and discectomy using 30 degrees and 45 degrees arthroscopes and specialized minimally invasive tools. Functional outcomes were assessed using the Japanese Orthopedic Association scoring system, Neck Disability Index, and visual analog scale for axial neck pain. Clinical efficacy was evaluated at the final follow-up using the modified Macnab criteria. RESULTS: All 11 patients successfully underwent posterior biportal endoscopic discectomy with a mean operative time of 82.7 +/- 10.1 minutes and mean estimated blood loss of 31.8 +/- 9.8 ml. The mean hospital stay was 5.2 +/- 1.1 days, and the mean follow-up period was 13.8 +/- 2.4 months. Significant improvements were observed in Neck Disability Index, Japanese Orthopedic Association, and visual analog scale scores. Clinical efficacy was rated as excellent in 3 patients, good in 6 patients, and fair in 2 patients according to the modified Macnab criteria. No cases of cervical instability or kyphosis were observed during postoperative follow-up. CONCLUSIONS: The novel posterior biportal endoscopic technique demonstrated significant clinical efficacy and safety in treating CCDH, with marked improvements in clinical outcomes, rapid postoperative recovery, and a low incidence of complications.

Abstract Background The traditional surgical procedures for upper lumbar disc herniation (ULDH) usually lead to frequent complications. We aim to investigate the clinical efficacy of the unilateral biportal endoscopy (UBE) technique in treating upper lumbar disc herniation (ULDH). Methods From January 2020 to December 2021, the clinical data of 28 patients with ULDH treated with the UBE technique were collected and analyzed for surgery time under UBE, postsurgical drainage, postsurgical hospital stay, and complications. The clinical efficacy was evaluated according to the modified MacNab score, Oswestry disability index (ODI), and visual analogue scale (VAS) of low back pain and lower limb pain before the surgery; one week, one month, and three months after the surgery; and at the last follow-up. Results All patients underwent the UBE surgery successfully. The surgery time under UBE for non-fusion cases was 47.50 ± 11.84 min (monosegment) and 75.00 ± 20.66 min (two segments), while that for fusion cases was 77.50 ± 21.02 min. The postsurgical drainage for non-fusion cases was 25.00 ± 13.94 mL (monosegment) and 38.00 ± 11.83 mL (two segments), while that for fusion cases was 71.25 ± 31.72 mL. The postsurgical hospital stay was 8.28 ± 4.22 days. The follow-up time was 15.82 ± 4.54 months. The VAS score for each time period after the surgery was significantly lower (P < 0.05), while the ODI was significantly higher than that before the surgery (P < 0.05). According to the modified MacNab scoring standard, the ratio of excellent to good was 96.43% at the last follow-up. Two patients experienced transient numbness and pain in their lower limbs and no activity disorder after the surgery, and they recovered after conservative treatment. Conclusions The clinical effect of UBE technique in treating ULDH was reliable. According to the needs of the disease, the interlaminar approach or paraspinal approach of the UBE technique was selected. This technique took into account the effect of treatment, achieved the purpose of minimal invasiveness, and did not require special instruments. Therefore, it has the potential for clinical application.

BackgroundThe technique of spinal decompression under endoscopy has been widely applied, but reports on endoscopic cervical fixation are rare. The unilateral biportal endoscopic (UBE) technique stands out for its lesser muscle intrusion and more flexible surgical approach.MethodWe applied the UBE approach for cervical fixation and laminectomy. We achieved bilateral lateral mass screw fixation by making an auxiliary UBE portal combined with the Roy-Camille and Magerl techniques.ConclusionsOur successful implementation of cervical fixation using the UBE technique at the C3/4 level suggests its efficacy. This approach is a valuable and minimally invasive option for cervical fixation.

Background Endoscopically assisted screw fixation with lumbar interbody fusion is rarely performed. We succeeded in implanting the cortical bone trajectory (CBT) screws under the guidance of unilateral biportal endoscopy (UBE). Method We attempted endoscopically assisted screw fixation in a patient with degenerative spondylolisthesis. Through a third portal, ipsilateral CBT screws were implanted without complications. Conclusions We successfully performed unilateral biportal endoscopic lumbar interbody fusion (ULIF) with CBT and reversed CBT screws. Compared with percutaneous pedicle screw (PPS) placement, this procedure is a minimally invasive, endoscopic alternative that allows precise screw placement.

Transforaminal lumbar interbody fusion (TLIF) with a single cage and bilateral pedicle screw fixation results in decreased stability or increased risk of cage displacement Wang and Guo (Comput Methods Biomech Biomed Eng, 24(3):308–319, 6). We succeeded in inserting double traversing cages with unilateral pedicle screw fixation (UPSF) during far lateral TLIF using unilateral biportal endoscopy (UBE). We attempted far lateral UBE-TLIF through two small incisions for degenerative lumbar spondylolisthesis with unilateral stenosis. With the help of novel instruments, far lateral UBE-TLIF with double traversing cages and UPSF was performed under tracheal intubation anaesthesia. We successfully performed far lateral UBE-TLIF with double traversing cages and UPSF. This procedure may be an alternative minimally invasive method for treating lumbar instability.