A Minimally Invasive L5-S1 Discectomy by Unilateral Biportal Endoscopy in A Patient of L5-S1 Intervertebral Disc Prolapse with S1 Nerve Root Compression: A Case Report

Introduction: A minimally invasive surgical procedure called unilateral biportal endoscopic discectomy is used to treat disorders of the cervical and lumbar spine, such as spondylotic radiculopathy and disc herniations. unilateral biportal endoscopic discectomy allows for efficient decompression with little tissue damage by using two tiny portals for endoscopic access. With applications spanning from the cervical to the lumbar regions, endoscopic spine surgery (ESS) has emerged as a dependable and successful alternative to open spine surgeries. The method performs multidirectional surgeries through two primary portals: the viewing and working portals. Case report: A 38-year-old female patient presented with intense left buttock pain for four months, causing tingling and numbness in her left lower limb. Her quality of life has been significantly compromised, with an Oswestry Disability Index score of 70%. Physical examination revealed a right-sided limp, muscle power at 5/5, and diminished sensory perception in the S1 dermatomal area. Pre-operative radiographic imaging showed no instability, but magnetic resonance imaging revealed a left-sided L5-S1 extruded disc compressing the S1 nerve root. Conclusion: Unilateral biportal endoscopic discectomy is a minimally invasive surgical technique that offers a smaller incision, less muscle trauma, and lower chances of infection and bleeding. It can be used in stenosis, far lateral disc herniation, and far lateral disc herniation. It offers excellent magnification and is cost-effective, using the same instruments as microdiscectomy. UBE is safe, with lower complication rates and few chances of dural tears, making it an excellent minimally invasive treatment option.