Novel Unilateral Biportal Endoscopy-Assisted Lumbar Fusion With Dual Hybrid Cage Insertion: A Technical Note With Case Presentation

Background: Minimally invasive spine surgery techniques, including unilateral biportal endoscopy (UBE), have become popular due to reduced soft tissue trauma and quicker recovery. Traditional lumbar fusion approaches using a single polyetheretherketone (PEEK) or expandable cage present limitations in fusion surface area and sagittal correction.Methods: We developed a novel UBE-assisted lumbar interbody fusion technique utilizing a dual hybrid cage system: a PEEK cage placed contralaterally and an expandable cage inserted ipsilaterally. The procedure was performed in 3 patients with degenerative lumbar disease, and perioperative outcomes were evaluated.Results: All patients experienced significant symptom relief, early ambulation, and radiologic evidence of fusion without complications. The dual-cage configuration improved segmental stability, restored lordosis, and maximized graft integration.Conclusion: This dual hybrid cage insertion method in UBE transforaminal lumbar interbody fusion provides a safe, effective, and minimally invasive strategy for lumbar fusion with promising clinical outcomes. Further studies are warranted to validate the long-term results.