Unilateral Biportal Endoscopy for Herniated Lumbar Disc

Herniated lumbar disc (HLD) is a common indication for unilateral biportal endoscopic (UBE) spine surgery. In cases of non-responsiveness to conservative treatment or neurological emergency with concomitant radiologic findings, UBE discectomy can be considered as a treatment option regardless of the degree of migration and consistency of the disc. Level identification, working space preparation, laminectomy, and ligamentum flavum removal are performed similarly to UBE decompression of spinal stenosis. With careful tissue dissection and root protection using a retractor, disc removal can be accomplished under high-definition camera guidance. Because of the various advantages of UBE such as less muscle injury, easy manipulation of bone, and disc removal with conventional punches and forceps, physicians can expect better outcomes including less postoperative back pain, shorter hospital stay, and higher patient satisfaction. The authors are confident of the important role of UBE discectomy as a minimally invasive surgery for HLD. In this article, we describe in detail the surgical procedure for UBE discectomy in an effort to assist our colleagues who wish to incorporate this technique in their practices.