J Minim Invasive Spine Surg Tech.  2025 Jan;10(Suppl 1):S75-S80. 10.21182/jmisst.2024.01718.

Unilateral Biportal Endoscopy-Assisted Thoracic Interbody Cage Insertion for the Treatment of Proximal Junctional Failure

• Kim HC
• Lee JY
• Cho HG
• Park JW
• Han SH
• Ko YI

• KMID: 2566284
• DOI: http://doi.org/10.21182/jmisst.2024.01718

Abstract

In the thoracic spine, when disc herniation causes cord compression in the anterior region, it is difficult to access the disc space. When using the unilateral biportal endoscopy (UBE) technique, the disc can be accessed from various angles with minimal damage to normal tissue. We performed cage insertion using UBE when treating a patient with thoracic myelopathy due to proximal junctional failure in the thoracic spine. A 77-year-old woman with prior spinal fusions and recent proximal junctional kyphosis presented with myelopathy. The patient first visited our hospital due to gait instability and decreased muscle strength that had occurred 2 months previously. The imaging findings confirmed cord compression due to disc herniation at the T10–11 level. Interbody fusion was performed at the T10–11 level using the UBE technique, and fusion was performed up to the T8 level. UBE offers a viable alternative to traditional approaches in thoracic spinal surgery, providing improved visualization and reducing pulmonary complications. This technique, combined with open surgery, effectively addresses the challenges of thoracic interbody cage insertion, demonstrating its potential to overcome the limitations of conventional methods.

Keyword

Unilateral biportal endoscopy; Thoracic interbody fusion; Thoracic myelopathy; Proximal junctional failure; Endoscopy-assisted interbody fusion