Short-Term Results of Biportal Endoscopic Spinal Surgery (UBE/BESS)

Abstract

Introduction: Biportal Endoscopic Spinal Surgery (UBE/BESS) is gaining attention as a minimally invasive surgical technique with high versatility. This study aimed to evaluate postoperative outcomes and complications of UBE/BESS.

Methods: A total of 320 patients who underwent UBE/BESS for lumbar disc herniation or lumbar spinal stenosis at our institution between April 2019 and July 2023 were retrospectively analyzed. Postoperative outcomes were assessed using the Visual Analog Scale (VAS) and the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) scores. Intraoperative and postoperative complications were also evaluated.

Results: Among 136 patients with lumbar disc herniation, VAS scores improved significantly for low back pain (55±30 to 12±17) and leg pain (74±23 to 10±15). JOABPEQ scores showed improvement across all domains. Similarly, in 184 patients with lumbar spinal stenosis, VAS scores for leg pain improved significantly (74±23 to 10±15), and JOABPEQ scores improved significantly in all domains. Intraoperative complications included one case of open conversion and six cases of dural tear, while postoperative complications included three cases of epidural hematoma, three cases of inferior articular process fracture, and one case of early recurrent herniation.

Conclusions: UBE/BESS is a safe and effective surgical technique with favorable postoperative outcomes. However, attention is needed to address complications specific to procedures performed under continuous irrigation.