Endoscopic unilateral laminotomy with bilateral discectomy using biportal endoscopic approach: Technical report and preliminary clinical results

Abstract Background Bilateral or huge disc herniations cause bilateral radiculopathy, as well as severe lower back pain. In such cases, a bilateral discectomy may be required to resolve the radicular pain in both legs. We attempted a surgical technique involving bilateral lumbar discectomy via a unilateral approach using a percutaneous biportal endoscopic approach. The purpose of this study was to present our surgical technique and investigate its clinical outcomes in symptomatic bilateral lumbar disc herniation. Methods Eleven patients with bilateral disc herniation of the L4-5 or L5-S1 segments were surgically treated using the percutaneous biportal endoscopic approach. A biportal endoscopic unilateral laminotomy with bilateral discectomy was performed in all patients. Postoperative magnetic resonance imaging was performed one day after surgery and clinical parameters were investigated preoperatively and postoperatively. Results All enrolled patients were successfully treated by biportal endoscopic bilateral discectomy via a unilateral approach. Operations were performed at the L4-5 level in one case and the L5-S1 level in 10 cases. The mean operation time was 67.5 ± 13.1 minutes. A visual analog scale of leg pain and the Oswestry disability index showed significant improvement after surgery (P Conclusion The endoscopic unilateral laminotomy with bilateral discectomy using the percutaneous biportal endoscopic approach could be an effective and alternative treatment for symptomatic bilateral herniated disc disease affecting L4-5 or L5-S1 segments.