Unilateral BIPORTAL endoscopic translaminar approach to treat up‐migrated lumbar disc herniation: 12 cases report

Abstract Objective There are difficulties on removing migrated disc herniation (MDH) using a microscope. The purpose of this study was to introduce a unilateral biportal endoscopic (UBE) translaminar approach to treat up‐migrated lumbar disc herniation (LDH). Patients and Methods A total of 12 patients from March 2021 to February 2022 with up‐migrated LDH were treated with a UBE translaminar approach. Clinical outcomes such as a visual analog scale (VAS) (back and leg pain) and MacNab criteria were assessed preoperative, postoperative, and 1 month after surgery. Results Seven patients were diagnosed with high‐grade up‐migrated LDH, while five patients presented very‐high grade up‐migrated LDH. In all cases, the migrated LDH were removed completely and were confirmed by postoperative magnetic resonance imaging. The VAS for back pain were improved from 4.5 (SD = 3.1) to 2.0 (SD = 1.0) and 1.0 (SD = 1.0) for immediately postoperative and in 1‐month follow‐up, respectively, showing a statistically significant difference ( p < 0.001). VAS for leg pain was 6.5 (SD = 2.5) preoperatively to 2.3 (SD = 1.1) and 0.8 (SD = 0.4) immediately postoperative and 1‐month follow‐up, respectively, also showing a significant difference ( p < 0.001). According to the MacNab criteria, we observed excellent outcomes in 66.6% and good outcomes in 33.3%. Conclusion The UBE translaminar approach showed a high success rate with high patient satisfaction for the management of up‐migrated LDH. It could be considered a feasible alternative surgical option to treat up‐migrated LDH.