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Review
. 2024 Jul;14(6):1838-1861.
doi: 10.1177/21925682241230465. Epub 2024 Feb 5.

The Method of Portal Making in Lumbar Unilateral Biportal Endoscopic Surgery with Different Operative Approaches According to the Constant Anatomical Landmarks of the Lumbar Spine: A Review of the Literature

Yixi Wang  1 , Abulikemu Maimaiti  2 , Abudusalamu Tuoheti  2 , Yang Xiao  2 , Rui Zhang  2 , Alafate Kahaer  2 , Dongshan Liu  2 , Paerhati Rexiti  2   3   4   5
Affiliations
Review

The Method of Portal Making in Lumbar Unilateral Biportal Endoscopic Surgery with Different Operative Approaches According to the Constant Anatomical Landmarks of the Lumbar Spine: A Review of the Literature

Yixi Wang et al. Global Spine J. 2024 Jul.

Abstract

Study design: Review.

Objective: Unilateral Biportal Endoscopy (UBE) is a minimally invasive surgery that is gaining recognition and being employed in clinical practice. Nevertheless, the precise method for determining UBE portals' location varies depending on the originator's preferences or the anatomical structure's proximity to the portal positions. Consequently, the relationship among UBE portals' locations is messy. This study aims to elaborate on the specific portal localization and explore the positional association and commonality among different UBE approaches' portals.

Methods: The following keywords are used to search in the PubMed, Ovid, Web of Science, ScienceDirect, SpringerLink, Scopus, CNKI, and Wanfang database: "Biportal endoscopic spinal surgery", "Two portal endoscopic spinal surgery", "Percutaneous biportal endoscopic decompression", "Unilateral biportal endoscopy", "Irrigation endoscopic discectomy", "UBE" and "BESS".

Results: After screening, 29 pieces of literature are included. The study summarizes different UBE approach portal localizations, categorized by fusion or non-fusion surgery and pathological classification. The study presents an inaugural method for categorizing the lumber into four surgical intervals based on bone landmarks and assigns different UBE approaches to the appropriate intervals based on their characteristics, making the selection of UBE surgical approaches' portal locations more flexible. Additionally, the study provides an overview of the indications, complications, and distinct benefits associated with each interval, further refining the novel UBE portal interval localization method.

Conclusion: The study clarifies the interrelationship and commonality between the portals of different UBE approaches and proposes a new UBE portal interval localization method to enhance surgeons' understanding and proficiency in UBE procedures.

Keywords: anatomical landmarks; incision; lumbar spine; portal making; unilateral biportal endoscopy.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of study selection.
Figure 2.
Figure 2.
Two mainstream portal positions of the UBE-interlaminar approach. (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Soliman; Red Dots: Wei Zhang.
Figure 3.
Figure 3.
Two mainstream portal positions of the UBE-transforaminal approach. (The dot size only provides a general indication and does not represent a specific proportion). Red Dots: Ahn; Green Dots: Zhu.
Figure 4.
Figure 4.
Two mainstream portal positions of the UBE technique to treat the PARS type I (The dot size only provides a general indication and does not represent a specific proportion). Red Dots: Liu; Green Dots: Duan.
Figure 5.
Figure 5.
Two mainstream portal positions of the UBE technique to treat epidural abscess. (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Kang; Red Dots: Zhang.
Figure 6.
Figure 6.
Three mainstream portal positions of the UBE-ULBD (LSS). (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Soliman; Red Dots: Hwa; Orange: Wang.
Figure 7.
Figure 7.
Two mainstream portal positions of the UBE-ULBD (SLSS). (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Tan; Red Dots: Hu.
Figure 8.
Figure 8.
Two mainstream portal positions of the UBE technique to treat ASD (Non-Fusion). (The dot size only provides a general indication and does not represent a specific proportion) Green Dots: Zhou; Red Dots: Zhu.
Figure 9.
Figure 9.
Two mainstream portal positions of the UBE-PLIF approach. (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Wang; Red Dots: Jiang.
Figure 10.
Figure 10.
Two mainstream portal positions of the UBE-TLIF approach. (The dot size only provides a general indication and does not represent a specific proportion). Green Dots: Park; Red Dots: Heo; Orange Dots: Lv; Blue Dots: Zhu.
Figure 11.
Figure 11.
The mainstream portal positions of the UBE-EFLIF approach. (The dot size only provides a general indication and does not represent a specific proportion).
Figure 12.
Figure 12.
The mainstream portal positions of the UBE technique to treat ASD (Fusion). (The dot size only provides a general indication and does not represent a specific proportion).
Figure 13.
Figure 13.
The mainstream portal positions of the UBE technique to treat lumbar spondylitis., (The dot size only provides a general indication and does not represent a specific proportion).
Figure 14.
Figure 14.
Schematic diagram of the portal location of different UBE approaches in the horizontal plane and coronal plane.
Figure 15.
Figure 15.
Schematic diagram of 4 anatomical intervals.
See this image and copyright information in PMC

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