A narrative review of current and future of Unilateral Biportal Endoscopic (UBE) transforaminal lumbar interbody fusion

With the ongoing development of Unilateral Biportal Endoscopic (UBE) spine surgery, it has become standard of care at many centers across the globe for lumbar decompressions and discectomies due to minimal muscle damage, minimal postoperative back pain and early recovery. In UBE, the separation of viewing portal and working portal allows greater freedom of movement for the surgical instruments as the camera and instruments move independently providing unrestricted vision. Moreover, the continuous irrigation fluid pressure decreases bleeding and helps to irrigate out the bone debris. Hence, UBE spine surgery has become quite popular and has expanded its indications to lumbar spinal fusion. The adoption of UBE for conventional spine surgeons into their routine practice is relatively easier than uniportal endoscopy because of use of standard arthroscopic lenses, familiar view of anatomy, and use of conventional open spinal instruments. In this article, we review the current literature and discuss the indications, contraindications, clinical outcomes, complications and compare it with existing minimally invasive transforaminal lumbar interbody fusion.