When a patient hears the word “surgery” it’s normal for them to have a lot of questions. And if the surgery involves something called biportal endoscopy of the spine, they will probably wonder exactly what that means, what the risks are, and if it can really help you recover your quality of life.
Fortunately, modern spine surgery has developed minimally invasive surgical techniques that make it possible to treat certain spinal problems with an approach that is much less aggressive to the body’s tissues. Biportal endoscopy is part of this evolution. In simple terms, it is a technique using two small routes of access: one for an endoscopic camera and the other for surgical instruments. This gives the surgeon a magnified view with which to work and access to the target area with less muscle damage than in conventional open surgery.
What problems can it treat?
Biportal endoscopy is used especially for certain patients with problems in the lumbar spine that cause nerve compression, something that can occur for example, with a lumbar disc hernia or lumbar canal stenosis. The objective of the procedure is usually to decompress the area and relieve pain radiating to the leg, as well as to improve functional ability that may have been limited when conservative treatments have not been successful.
Thanks to recent progress, biportal endoscopy can also be used for revision surgery in the lower back, interbody vertebral fusion (placement of interbody cages between the vertebrae), and treating problems of the cervical spine, such as hernias or cervical canal stenosis. More advanced techniques also allow us to use this procedure to treat pathologies of the thoracic spine.
What makes it so interesting for patients?
Because when the right surgical technique is indicated, what most people look for are three things: least aggressive surgery, an easier recovery process, and to be able to gradually resume their normal daily life. In general, with minimally invasive surgery, there is less soft tissue damage, less postoperative pain, and a shorter hospital stay than with more traditional surgical approaches, although it always depends on the case and the type of procedure.
With this procedure, patients usually leave the hospital walking on their own after a 24-hour hospital stay. Depending on the patient, sometimes they are even able to go home on the same day!
Can this procedure be used for every patient?
The answer is no, and it’s important to be clear about this. The fact that a technique is modern or minimally invasive does not mean it is the best option for every patient’s case. The right procedure and technique depend on the specific diagnosis, the degree of nerve compression, the anatomy of the patient, whether there is vertebral instability, and whether or not previous treatments have failed. Clinical guidelines for treating lumbar herniation or lumbar canal stenosis are very clear: the surgical decision must always be on a case-by-case basis, taking into account the specific situation of the individual patient.
Nonetheless, it presents a new option for a range of ideal candidate patients: older adults not in condition to withstand long instrumentation surgery, and young adults with a need to quickly get back to work if they are self-employed, or resume their sports if they are high-level athletes.
When should you see a specialist?
If your suffer low back pain or sciatica that limits your daily life, or you notice tingling or weakness in your legs and walking becomes more and more difficult, or when conservative treatments you have tried are no longer helping, getting checked out by a specialist will allow you to find out if you might be a candidate for biportal endoscopy, or if there is another option more suitable for you.
In summary
Biportal spine endoscopy is a minimally invasive technique that can be of great help for treating certain lumbar problems, especially when there is nerve compression and conservative treatments have not succeeded. It is a minimally invasive option that can be used on well-selected patients, and is another “weapon” in our arsenal of procedures that can help you regain your quality of life.
Dr. Xavier Santander
Neurosurgeon
Categories: Spine treatments, Surgery, Techniques