As a board-certified orthopedic spine surgeon with over 20 years of expertise, Dr. Hooman Melamed at The Spine Pro in Beverly Hills, CA, is at the forefront of biportal endoscopic spine surgery (BESS). Recognized as one of the first U.S. surgeons to master this technique, Dr. Melamed has helped thousands avoid invasive fusions through his narcotic-free, holistic approach since 2018. Featured on Dr. Oz, The Doctors, and Fox News, and honored by Castle Connolly as a Top Doctor, he delivers world-class care to patients from Los Angeles to international locales like London and Dubai.
What Is Biportal Endoscopic Spine Surgery (BESS)?
BESS represents the gold standard in ultra-minimally invasive spine surgery, using two small incisions (¼ to ⅓ inch) tailored to your anatomy and pathology. One portal inserts a thin fiber-optic camera for a magnified, panoramic view, while the other allows instrument passage for precise work—like removing bone spurs or herniated discs. This dual-portal system bypasses healthy tissues, preserving spinal stability and minimizing scarring.
Unlike traditional open surgery, BESS is outpatient at Cedars-Sinai Medical Center, with most patients discharged the same day. A 2025 meta-analysis confirms BESS’s superiority in reducing tissue trauma and hospital stays compared to microscopic approaches.
Why BESS Outperforms Uniportal Endoscopic Spine Surgery
Single-portal (uniportal) endoscopic surgery limits surgeons to a 2D view, restricting access and often requiring toxic methylene blue dye for disc identification, which can cause complications. BESS’s independent portals provide 3D flexibility, continuous irrigation to lower infection risks (down to <1%), and no dye is needed.
A recent multicenter study (2025) shows BESS treats more pathologies with fewer revisions than uniportal methods, boasting complication rates as low as 2.2%.
Advantages of Biportal Endoscopic Spine Surgery
BESS offers unmatched benefits, backed by 2025 research:
- Superior Visualization and Access: Magnified views allow precise targeting, treating complex cases like multilevel stenosis.
- Motion-Sparing and Stability-Preserving: Avoids fusions, reducing long-term instability risks.
- Low Complication Rates: Under 3%, including minimal blood loss and infection.
- Rapid Recovery: Narcotic-free with holistic support (e.g., gut health optimization); drive in 2-3 days, full activity in 4 weeks.
- Cost-Effective: Lower hospital costs than open procedures, per 2023-2025 data.
Conditions Treated with BESS
Dr. Melamed uses BESS to address:
- Herniated/Bulging Discs
- Spinal/Foraminal/Lateral Recess Stenosis
- Sciatica and Radiculopathy
- Degenerative Disc Disease and Spondylosis
- Spondylolisthesis and Spondylolysis
- Low Back Pain, Neurogenic Claudication, Foot Drop
- Failed Back Surgery Syndrome, Far-Out Syndrome, Bertolotti Syndrome
How BESS Is Performed: Step-by-Step
- Pre-Op Evaluation: MRI/CT scans and holistic assessment.
- Incisions: Two tiny portals based on your anatomy.
- Visualization: Camera insertion for real-time HD view.
- Procedure: Instruments remove pathology; portals swap as needed.
- Closure: Bandages only—no stitches.
Potential Complications and Risks
Though rare (<1% with Dr. Melamed), risks include spinal fluid leaks, nerve irritation, or reherniation. 2025 studies report lower rates in BESS vs. open surgery (2.7% vs. 15.9%). Discuss with Dr. Melamed for personalized insights.
Recovery Timeline for BESS in 2025
- Day 0: Same-day discharge; Tylenol for pain.
- Days 1-3: Light activity, driving possible.
- Weeks 2-3: Start physical therapy.
- Month 1: Full activities, per therapist clearance.
Patients report 90% satisfaction, far exceeding traditional methods.
Patient Stories and Testimonials
John from LA: “BESS fixed my sciatica without fusion—back to golf in weeks!”
Pauline from Florida: “Dr. Melamed helped me avoid fusion. It was so worthed to fly to Los Angeles and get this ultra minimally invasive endoscopic spine surgery. I flew back pain free 2 days later.”
Scott from Hawaii: “As a dentist myself, 2 spine surgeons wanted to fuse my spine and it was at the wrong level! Instead Dr. Melamed identified the herniated disc at the correct level and performed his magic BESS procedure. I woke up pain free left hospital same day and flew home 2 days later. Now back to all my activities pain free.”
Frequently Asked Questions (FAQs)
- What is the difference between BESS and uniportal? BESS offers better flexibility and lower risks.
- Is BESS covered by insurance? Yes, out-of-network benefits apply; we verify for you.
- Can international patients access BESS? Absolutely—virtual consultations available.
Learn More and Schedule
Contact The Spine Pro today for a consultation. Revolutionize your spine health with Dr. Melamed’s BESS. [email protected] or 424-21-SPINE
