Neurospine.  2019 Mar;16(1):138-147. 10.14245/ns.1836330.165.

Biportal Endoscopic Spinal Surgery for Bilateral Lumbar Foraminal Decompression by Switching Surgeon's Position and Primary 2 Portals: A Report of 2 Cases With Technical Note

  • 1Department of Neurosurgery, Him-Plus Neurosurgery Clinic, Suncheon, Korea.
  • 2Department of Neurosurgery, St Peter's Hospital, Seoul, Korea.
  • 3Department of Neurosurgery, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.


Total facetectomy with/without fusion and facet-preserving microforaminotomy have been performed as conventional surgical treatments for lumbar foraminal stenosis (LFS). Recently, endoscopic spinal surgery has been introduced as a minimally invasive therapeutic modality of LFS by several authors. We report two cases of bilateral LFS at lumbosacral junction level successfully treated with a novel biportal endoscopic spine surgery (BES) technique using primary 2 portals. Two patients presented with chronic onset of back pain and neurogenic claudication symptom. They were diagnosed with bilateral LFS at L5-S1 level from magnetic resonance imaging and computed tomography preoperatively. BES for bilateral foraminal decompression was performed via contralateral approach bilaterally without additional skin incision or surgical trajectory by switching surgeon's position and primary 2 portals. After the surgery, preoperative patients' back and leg pain resolved and unilateral leg weakness of the 2 patients gradually improved in a few months. Postoperative radiologic images revealed significantly enlarged bilateral foramens at L5-S1 level.


Biportal endoscopic spine surgery; Bilateral lumbar foraminal stenosis; Minimal invasive; Contralateral approach

MeSH Terms

Back Pain
Constriction, Pathologic
Magnetic Resonance Imaging
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