3D-Navigation guided sublaminar contralateral unilateral biportal endoscopy (UBE) for migrated foraminal disc in the lumbar spine: A technical note and case series

Background: Migrated lumbar foraminal disc herniation (FDH) poses a great challenge, requiring the facet joint resection and stabilization procedure. We used a contralateral sublaminar unilateral biportal endoscopic (UBE) approach utilizing O-arm navigation to preserve the facet and effectively resect a FDH. Methods: Through the sublaminar window, resecting the ligamentum flavum, performing a limited medial facetectomy using O-arm navigation, safely exposed the foraminal zone, allowing for the safe FDH resection. Results: Fourteen patients underwent this procedure between 2022 and 2023. Mean operative time was 75 min with minimal blood loss and no perioperative complications. Visual analog scale scores improved markedly: back pain decreased from 8.6 preoperatively to 0.8 at 12 months, and leg pain from 9.2 to 0.4. Radiological analysis showed an average 5.1% reduction in facet joint area without new instability or spondylolisthesis. Conclusion: Utilizing O-arm navigation, the contralateral sublaminar UBE approach enables safe, precise, and facet-preserving decompression for FDH.