Reaches of Unilateral Biportal Endoscopy in Lower Thoracic and Lumbar Spinal Extramedullary Tumor Resection: Case Series, Surgical Note, and Outcomes

Background: Extramedullary spinal tumors represent a significant challenge for spine surgeons. Currently, various techniques exist to perform tumor resection safely while optimizing patient outcomes. Historically, the standard of care has been open surgery; however, in the last two decades, Minimally Invasive Spine Surgery (MISS) techniques have gained importance due to superior postoperative recovery. Literature on Unilateral Biportal Endoscopy (UBE) for tumor resection is currently limited. We propose that UBE has the potential to become a standard approach for these lesions due to its distinct advantages. Methods: We performed a retrospective review of 11 patients who underwent UBE resection of lower thoracic and lumbar spinal extramedullary tumors. We analyzed clinical files and intraoperative endoscopic videos to describe our surgical technique step by step. We also evaluated the advantages of this approach in terms of resection rate, operative time, operative blood loss, and hospital stay. A representative case is also presented. Results: Clinical resolution and significant symptomatic improvement were achieved in all cases, as evidenced by functional and pain scales. In terms of tumor resection, we obtained results comparable to other MISS techniques and open surgery, with a low complication rate. Conclusions: UBE represents a safe, effective evolution in MISS for spinal tumors. Future studies with larger cohorts are needed to validate these findings as a standard of care.