2.4.2. UBE Group (UBE Two-Channel Technology Group)

All cases underwent endotracheal intubation anesthesia and surgery in the prone position. Two skin incisions were made under C-arm fluoroscopic guidance. The initial target point of the mirror instrument is located at the junction of the spinous process and the lamina, so as to make a horizontal marking line and draw a marking line along the inner edge of the pedicle. Intersection of two lines and 1.5 cm, respectively, to observe incision and incision operation point of the body surface. And we made 2 portals, layer by layer, the lumbar and dorsal fascia was cut longitudinally, and the soft tissue covered by the bony surface of the lamina was gradually expanded and bluntly separated to form the observation portals and the working portals. In the observation portals, the arthroscopic system was inserted and use salt water irrigation, under the hydraulic pressure to make tiny intra-spinal canal vein, does not ooze blood; it keeps to the field of vision clear; smooth flow of water is the key to UBE to get clear operative field. In the working portals, the soft tissue on the surface of the intervertebral space was treated under the 90° plasma scalpel and hemostasis was performed. Lamina rongeur and arthroscopy of the operating system dynamic power drill were used to remove the target intervertebral disc under the upper edge of vertebral lamina and a vertebral lamina edge, the edge of exposure on the yellow ligament, and the removal of yellow ligament. Using nerve hook open, nerve root, and dural sac intervertebral disc, preoperative MRI image data suggest peering into spinal canal and vertebral bodies with nucleus pulposus clamp fall off removal of nucleus pulposus, under endoscopic direct from removed off to the nucleus pulposus in the back part of the vertebral bodies.

Typical Case 1: Patient, male, 46 years old, L4 5. After intervertebral disc prolapse and intervertebral foraminal endoscopic nucleus pulposus extraction (Figures ​(Figures33 and ​and4),4), MRI lost its shape and position before and after operation. It can be seen that there are still some residual compression nerve roots of nucleus pulposus after operation.

Incision of two approach (a: incision after single-channel endoscopy; b: incision after two-channel UBE.).

MRI imaging of typical case 1 (a: MRI sagittal of L4. Five intervertebral disc herniation before operation; b: MRI sagittal of L4. Five intervertebral disc after prolapse poroscopy; c: coronal MRI of L4. Five intervertebral disc herniation before operation; d: coronal MRI of L4. Five intervertebral disc herniation after prolapse poroscopy.).

Typical case 2: Patients, male, 60 L2.3 slipped disc, line UBE dual channel after percutaneous minimally invasive nucleus pulposus enucleation (Figure 5), preoperative and postoperative MRI 3 loss with coronary, visible after removal of nucleus pulposus thoroughly, and no leave of nucleus pulposus.

MRI imaging of typical case 1 (a: MRI sagittal of L2. Three intervertebral disc herniation before operation; b: MRI sagittal of L2. Three intervertebral disc after prolapse poroscopy; C: coronal MRI of L2. Three intervertebral disc herniation before operation; D: coronal MRI of L2. Three intervertebral disc herniation after prolapse poroscopy.).