SPINE
Uniportal Endoscopic Spine Surgery
A single access of a few millimeters through which the camera and the instruments pass together.
Book an evaluationMasked surgeon operating a 3D image-guided navigation device in an operating room
Dr. Victor BatistelaNeurosurgeonCRM-PR 35044 · RQE 30580 (Brazilian medical registration)
What it is
Camera and instruments through the same path
In uniportal endoscopic surgery, the surgeon reaches the spine through a single access — an incision of a few millimeters, generally smaller than one centimeter. Through it passes the endoscope: a thin tube that carries the camera, the light, saline irrigation and a working channel through which the instruments enter. Everything happens inside this same tube.
The image is magnified on a monitor, and the surgeon operates while looking at the screen, very close to the structure being treated. The path to the spine passes between the muscle fibers, rather than cutting or widely retracting them — this is the reason the endoscopic approach exists.
"Uniportal" describes the number of accesses, not a specific procedure. The technique can be used to remove a herniated fragment, widen the opening through which the nerve exits or, in selected cases, as part of a spinal fixation.
Conditions that can be treated
Herniation, stenosis and disc degeneration, in selected cases
The uniportal route may be indicated, in selected cases, for a lumbar or cervical herniated disc that compresses a nerve and does not improve with conservative treatment; for spinal stenosis, when the narrowing is at a defined point, such as the foramen through which the root exits; and for degenerative disc disease in specific situations, evaluated at the appointment.
In some cases, spinal fusion — the fixation of a segment of the spine — can also be performed with endoscopic support, reducing the opening required. This indication is restricted and depends on the level, the anatomy and the cause of the instability.
- Herniated disc
- Spinal stenosis
- Degenerative disc disease
- Endoscopically assisted spinal fusion, in selected cases
Anatomy
Where the single access goes in
The access point is beside the spine, at the level of the problem. The camera and the instruments pass through the same tube.
- 1
Single access point
The incision of a few millimeters, beside the lumbar spine. Through it enters the endoscope with the camera and the working channel.
- 2
Intervertebral disc
The cushion between two vertebrae. The herniation is the part of it that has moved out of place and presses on the nerve.
- 3
Nerve root
The nerve that exits the spine at each level. When compressed, it causes the pain that radiates to the leg or arm.
What the path looks like
Four steps, in this order
The technique is defined at the end of the process, not at the beginning. Before it come the conversation, the examination and the imaging.
Step 01
Appointment and physical examination
Where the pain starts, where it goes, what makes it worse. Strength, sensation and reflexes locate the affected nerve.
Step 02
Imaging tests
The MRI shows the type and position of the herniation or narrowing — data that weigh on the choice of route.
Step 03
Discussion of the plan
Conservative treatment first, except in cases of neurological deficit. If surgery is indicated, the route is defined: uniportal, biportal, microdiscectomy or another.
Step 04
Follow-up
Gradual return to activities and guided rehabilitation. Follow-up visits check pain and function.
What changes in the approach
Uniportal or biportal
Both are endoscopic techniques and treat the same problems. The difference lies in the number of accesses and the way of working.
Uniportal
- A single access of a few millimeters
- Camera and instruments pass through the same tube
- Fine instruments, adapted to the working channel
- Indicated in selected cases, depending on level and anatomy
Biportal
- Two small accesses, close to each other
- Camera through one access, instruments through the other
- Instruments similar to those of conventional surgery
- Indicated in selected cases, depending on level and anatomy
Neither is superior to the other in all cases. The choice depends on the problem, the spinal level and the team's experience with each technique — and is made during the evaluation.
When not to wait
Signs that should not wait for an appointment
These signs call for the emergency room, not an elective appointment.
- sudden loss of strength in the leg or arm
- difficulty controlling urine or bowel
- numbness between the legs
- severe pain after trauma
Frequently asked questions
- The number of accesses. In the uniportal technique, camera and instruments pass through a single tube, through one incision. In the biportal technique, there are two small incisions: one for the camera, another for the instruments. The choice between them is made during the evaluation.
- No. It may be considered in selected cases, depending on the type, size and position of the herniation, as well as the person's anatomy. Very large herniations, those with fragments migrated far away, or cases with instability usually call for another technique.
- It depends on the case. Some uniportal procedures can be performed with sedation and local anesthesia; others, under general anesthesia. The anesthesia team defines the option suited to each person.
- It varies according to the procedure and each person's progress. In general, the hospital stay for endoscopic surgeries is short; the exact time is discussed before surgery, not promised.
- Yes. As with any technique for treating a herniated disc, there is a possibility of recurrence. Follow-up and rehabilitation help reduce this risk, but it is not zero.
Read also
Book an evaluation
The appointment serves to understand the condition and define the next step. Not every condition requires surgery.
This channel is not a substitute for emergency care. In an emergency, go to the nearest emergency room.
