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Ultra-Minimally Invasive Biportal Endoscopic Spine Surgery

Minimally Invasive Treatment Options Designed Around You

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Recent advances in spine surgery have allowed spine surgeons to use minimally invasive techniques to fix the spine pathology. Unfortunately, as a result spinal fusion cases have also increased in the last decade in the United States.

For the right reasons, a spinal fusion can be extremely beneficial and help patients regain a pain-free lifestyle. However, fusion long-term has its own setbacks. For example, the more lumbar levels a patient has fused, the more likely they are going to need additional fusions much sooner down the road.

Avoid Spinal Fusions with Biportal Endoscopic Spine Surgery

Endoscopic spine surgery takes the minimally invasive approach to a whole new level. Many surgeons perform endoscopic spine surgery using a single portal. The problem with a single portal is that the surgeons are limited to what they can do, taking a three-dimensional operation and making it into a two-dimensional operation.

Biportal endoscopic spine surgery utilizes two independent portals for viewing and working where these portals are exchangeable. This allows surgeons to maintain a certain distance from the bony and neural structures, which allows closer access to the target lesion through a panoramic magnified view.

The advantages of biportal endoscopic spine surgery include:

  • Boasts excellent magnification
  • More flexibility
  • Far better access
  • More pathologies may be treated
  • Preserves stability
  • Low complication rates
  • Decreased potential for long-term instability
  • Continuous irrigation where infection rate becomes so very minimum

Dr. Melamed’s Revolutionary Approach to Spinal Fusions

Over the years, Dr. Melamed was becoming unhappy and dissatisfied with the invasive spinal fusion approach. After much deliberation and research, Dr. Melamed learned about endoscopic spine surgery, more specifically BESS. He took it upon himself to get educated and properly trained in this revolutionary new approach by visiting master surgeons outside of the United States.

What is Biportal Endoscopic Spine Surgery aka BESS?

BESS is an ultra-minimally invasive spine surgery approach. Two incisions, roughly a quarter to a third of an inch, are made considering the pathological lesion site and the patient’s anatomical variation.

Through one portal which is one of the incisions, a very thin fiber-optic video cameras, is inserted into the body, allowing the surgeon to use one portal for viewing and the other portal which is the other incision for working. Surgery is performed by passing instruments through the “working” endoscope to remove bone spurs or disc material. Essentially you end up bypassing all the normal structures of the body and the camera exactly ends up in the area where the actual pathology is. This way one preserves all the normal structures which allows long term far better function and much less scarring At the end of the procedure, the endoscope is removed and only a small bandage is needed to cover the incision area.

Common conditions treated under biportal endoscopic spine surgery include:

  • Spinal stenosis
  • Foraminal stenosis
  • Lateral recess stenosis
  • Sciatica
  • Spondylolisthesis
  • Radiculopathy
  • Radiculitis
  • Degenerative disc disease
  • Spondylosis
  • Spondylolysis
  • Disc herniation
  • Low back pain
  • Foot drop from pinched nerve
  • Back pain
  • Neurogenic claudication
  • Herniated disc
  • Pinched nerve

The BESS technique has been revolutionary in saving countless patients from having a fusion operation. The biportal endoscopic surgery allows the surgeon to create a tunnel by removing the excess bone spur and/or herniated disc pinching the nerve when the disc spaces collapse.

The surgeon is able to decompress the nerve without sacrificing any of the stability. The biportal technique also allows decompressing the spinal canal by bypassing all of the normal structure, shaving down the bone spurs and removing the herniated disc, but preserving all of the normal anatomy, which means a much higher long-term success rate. This has taken microdecompression operation to a whole new level and just cleaning out the excess bone spur and removing the herniated disc without sacrificing the normal anatomy and no retractors are needed.

What are the Potential Complications?

All surgeries, regardless of how minimally invasive, are still considered surgery and can have their own specific complications. When it comes to spine surgery including BESS complications even, such as a spinal fluid leak, nerve injury, and reherniation, reoperation among others, although extremely small, can still have risks. Please talk to your surgeon about any potential risks if you have chosen to have any kind of spine surgery including BESS.

What is the Recovery Time?

BESS is an advanced, state-of-the-art form of ULTRA minimally invasive spine surgery designed to provide patients with a shorter procedure and a quicker recovery time, with most patients going home the same day of surgery and perhaps only requiring Tylenol and over the counter anti-inflammatories.

Patients will have a remarkably fast recovery with driving within a couple of days and starting physical therapy within two-three weeks post-operation and back to full activity as soon as cleared by a physical therapist.

Learn More About Biportal Endoscopic Spine Surgery

If you are interested in learning more about BESS, call the SpinePro team of Dr. Hooman M. Melamed to start getting your life back on track.

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