Expanded application of unilateral biportal endoscopy in adult thoracic disease: report of three cases and literature review

Background: Traditional surgery for degenerative thoracic disorder can be extremely invasive and accompanied by complications. Unilateral biportal endoscopy (UBE), a newly developed technique in the field of spin surgery, is minimally invasive and its popularity and indications have been increasing. In this study, we report three cases of different thoracic diseases treated using UBE.

Methods: The first case was a 50-year-old male patient with lower extremity tingling sense and right thigh anterior aspect radiating pain. Bilateral decompression and removal of ossification of the ligamentum flavum (OFL) was done. The second case was a 75-year-old female who had symptoms of gait disturbance and motor weakness due to thoracic myelopathy in T12-L1. We performed canal decompression and discectomy using the far-lateral approach. The third case was a 69-year-old female with poor medical condition due to lymphoma who had symptoms of right intercostal pain that occurred after T12 acute compression fracture. UBE treatment was decided, and nerve decompression was performed.

Results: In the first case, the tingling sense due to OYL improved three months after the surgery. In the second case, the right lower extremity radiating pain and gait disturbance showed improvement after surgery, but motor weakness continued until four months after surgery. In the third case, intercostal pain showed improvement immediately after surgery.

Conclusion: Although UBE surgery is limited in completely replacing traditional treatments for degenerative thoracic disease, it offers the advantages of rapid rehabilitation and short-term hospitalization and can be a good surgical treatment option.