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Video · Explainer

Procedure – Biportal Endoscopic Spine Surgery vs. Traditional Fusion

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Biportal Endoscopic Spine Surgery vs. Traditional Fusion · Dr. Hooman Melamed on YouTube

Published on YouTube Length 2:39

About this video

Dr. Melamed explains what biportal endoscopic spine surgery means: two small entry points, one for a camera and one for the instruments. He describes using it to remove a herniated disc fragment or shave down bone spurs without cutting through the muscles and ligaments. He says most patients don't need fusion, that fusion is still an option if the endoscopic approach doesn't work, and that most patients start physical therapy within 2 weeks.

Medically reviewed byDr. Hooman Melamed, MD, FAAOS

Transcript

From the video's automatic YouTube captions, edited for punctuation, capitalization and paragraph breaks. Filler sounds such as "um" are left out, and clearly misheard names and medical terms are corrected. Words that could not be made out are marked [inaudible].

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There’s no cutting, there’s very little blood loss. Beautiful thing, the recovery, you’re up and about right away. And so this is what’s called a biportal endoscopic spine surgery. Check it out.

What is biportal endoscopic spine surgery? The word bi means two. Portal means entrance. So that means two entrance. Traditionally, endoscopic spine surgery is done to make a little tiny hole, you go in there. Why is two portals better? Because two portal allows you a much better access, much better visualization, a better field, and at the same time you have much more flexibility with your instruments.

Why endoscopic surgery? Because you avoid incision on the spine. Beautiful thing about endoscopic spine surgery is that you literally make an incision about a quarter of an inch. Somewhere outside here, away from the spine, make a little incision, and with a camera, so you put a little camera about this big, you go with the camera, you’re literally looking down here, and then through the other portal, another incision next to it, you have your working instruments. So the camera is looking here, you’re looking here. You’re bypassing all of the muscles here, all of the ligaments, all of the tendons, you’re not cutting anything, you just make it straight go down, and you literally just work in the area where the problem is.

For example, let’s say here, if the nerve is compressed here, you come down here, identify the nerve, and you go around the nerve, you remove the herniated fragment. Or if there’s bone spurs here, endoscopically you can come in, shave down the bone spur. Most patients don’t need fusion, but you can come endoscopically, clean everything out, and avoid a fusion. The beautiful thing is that you’re not burning any bridges. So even if the endoscopic doesn’t work, you can still do fusion or other things. Why not try endoscopic operation?

There’s no cutting. There’s very little blood loss. Beautiful thing, the recovery. You’re up and about right away. Start physical therapy within 2 weeks and ramp up from there and then you’re good to go. Most patients, all they need is just some Tylenol, maybe some anti-inflammatory afterwards. They don’t even know they had surgery. They’re just a little bit sore. So, this is what’s called a biportal endoscopic spine surgery. Check it out.

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