Unilateral Biportal Endoscopic Translaminar Keyhole Approach to Treat High-grade Up-migrated Lumbar Disc Herniation: Technical Note

The incidence of lumbar disc fragment migration is approximately 35%–72% of which 34% are high-grade up-migrated discs. Translaminar keyhole approach is a minimally invasive and true tissue sparing technique which has been applied to approach migrated disc herniation. The unilateral biportal endoscopic approach is an emerging technique among endoscopic spine surgery that combines the advantages of microscopic surgery with endoscopic surgery. In this technical report we demonstrate the surgical technique of performing the translaminar keyhole approach with unilateral biportal endoscopic spine surgery to treat high-grade up-migrated discs. As far as we know, this is the first technical report of unilateral biportal endoscopy with translaminar keyhole approach to treat high-grade up migrated lumbar disc herniation.