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Surgical neurology international · 2026

3D-Navigation guided sublaminar contralateral unilateral biportal endoscopy (UBE) for migrated foraminal disc in the lumbar spine: A technical note and case series.

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Hadgaonkar Shailesh, Shah Parth K, Sancheti Parag K

Аннотация

BACKGROUND: Migrated lumbar foraminal disc herniation (FDH) poses a great challenge, requiring the facet joint resection and stabilization procedure. We used a contralateral sublaminar unilateral biportal endoscopic (UBE) approach utilizing O-arm navigation to preserve the facet and effectively resect a FDH.

METHODS: Through the sublaminar window, resecting the ligamentum flavum, performing a limited medial facetectomy using O-arm navigation, safely exposed the foraminal zone, allowing for the safe FDH resection.

RESULTS: Fourteen patients underwent this procedure between 2022 and 2023. Mean operative time was 75 min with minimal blood loss and no perioperative complications. Visual analog scale scores improved markedly: back pain decreased from 8.6 preoperatively to 0.8 at 12 months, and leg pain from 9.2 to 0.4. Radiological analysis showed an average 5.1% reduction in facet joint area without new instability or spondylolisthesis.

CONCLUSION: Utilizing O-arm navigation, the contralateral sublaminar UBE approach enables safe, precise, and facet-preserving decompression for FDH.