Journal of neurosurgery. Case lessons · 2026
Utility of the scope retractor for adhesiolysis in unilateral biportal endoscopic lumbar surgery: illustrative cases.
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Lee Changik, Kim Young-Jin, Kim Jin-Sung
Аннотация
BACKGROUND: During unilateral biportal endoscopic (UBE) lumbar surgery, adhesiolysis can be technically challenging compared with microscopic lumbar surgery because of the constraints imposed by single-handed manipulation. The authors evaluated the use of a scope retractor as an adjunctive tool to facilitate bimanual-like tissue handling.
OBSERVATIONS: Two illustrative cases with severe epidural adhesions-one related to postoperative scarring and the other associated with chronic inflammation from a synovial cyst-were treated with the aid of a scope retractor, which was used either to secure adhesive tissue or as a dissecting instrument. Successful adhesiolysis and adequate neural decompression were achieved in both cases.
LESSONS: UBE surgery provides high-quality visualization that enhances differentiation between the dura mater and surrounding soft tissue. Incorporation of a scope retractor facilitates precise tissue handling by providing an effect analogous to bimanual manipulation, improving surgical outcomes in cases with severe epidural adhesions. https://thejns.org/doi/10.3171/CASE26223.
OBSERVATIONS: Two illustrative cases with severe epidural adhesions-one related to postoperative scarring and the other associated with chronic inflammation from a synovial cyst-were treated with the aid of a scope retractor, which was used either to secure adhesive tissue or as a dissecting instrument. Successful adhesiolysis and adequate neural decompression were achieved in both cases.
LESSONS: UBE surgery provides high-quality visualization that enhances differentiation between the dura mater and surrounding soft tissue. Incorporation of a scope retractor facilitates precise tissue handling by providing an effect analogous to bimanual manipulation, improving surgical outcomes in cases with severe epidural adhesions. https://thejns.org/doi/10.3171/CASE26223.