An Alternative Portals Placement Method for Lumbar Disc Herniation or Stenosis With Unilateral Biportal Endoscopic Technique: A Technical Note and Preliminary Clinical Results.

Abstract

Prospective randomised clinical study. To compare the effectiveness of the Right Triangle (RT) method with the traditional UBE(unilateral biportal endoscopic) method in UBE surgery for lumbar disc herniation or stenosis, focusing on surgical efficiency and radiation exposure minimization. UBE technique is a minimally invasive approach for spinal surgeries. This study introduces the RT method as an alternative during UBE procedures, aiming to enhance surgical efficiency and minimize radiation exposure. We conducted a prospective analysis of 91 consecutive patients who underwent UBE surgery using either the traditional method (43 cases) or the Right Triangle (RT) method (48 cases) between Dec 2022 and Dec 2023. All data were collected prospectively with a minimum follow-up of 12 months. Both groups demonstrated comparable improvements in VAS and ODI scores. However, the RT method exhibited significant advantages in terms of reduced operative time (62.7±5.7 min for traditional UBE vs. 56.8±6.9 min for RT) and fewer fluoroscopy shots (3.9±0.74 for traditional UBE vs. 2.6±0.61 for RT). The RT method within UBE practice offers a promising alternative that effectively shortens operative time and decreases reliance on intraoperative x-ray fluoroscopy. As operator proficiency increases, operative time is expected to decrease further, particularly in cases with left-sided symptoms. Level 3.