ArticleAsian spine journal2024
Biportal endoscopic en bloc removal of the ligamentum flavum for spinal stenosis: nuances for the "butterfly" technique.
Article in Asian spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- One-hole split endoscopy versus unilateral biportal endoscopy for lumbar degenerative disease: a systematic review and meta-analysis of clinical outcomes and complications.Journal of orthopaedic surgery and research · 2025Pooled it
- Utility of the scope retractor for adhesiolysis in unilateral biportal endoscopic lumbar surgery: illustrative cases.Journal of neurosurgery. Case lessons · 2026Article
- Lumbar spinal stenosis: current concept of management.Asian spine journal · 2026Article
- Application of the far-lateral approach in uni-portal non-coaxial spinal endoscopic surgery: an evidence-based and Delphi consensus approach among Chinese expert opinions.Brain & spine · 2026Article
- O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study.Asian spine journal · 2025Article
- Three types of ligamentum flavum resections for the treatment of lumbar central canal stenosis: BUTTERFLY retrospective study.Asian spine journal · 2025Article
- En bloc resection of the ligamentum flavum for bilateral decompression in unilateral biportal endoscopic transforaminal lumbar interbody fusion: a 2-year follow-up study.Journal of orthopaedic surgery and research · 2024Article
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2 authors.
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Abstract
The introduction of endoscopic spine surgery has led to a paradigm shift in the treatment of spinal disorders. In particular, biportal endoscopic surgery has gained traction for its wider visual field and improved the maneuverability of instruments, familiar anatomy, and costeffectiveness. In this study, we describe our en bloc removal of the ligamentum flavum using a "butterfly" technique. This approach had several advantages: (1) The flavum serves as a protective barrier for the dura during drilling. (2) There is less epidural bleeding, which provides (3) better visualization. (4) In an inadvertent durotomy, this usually occurs later in the procedure, which is more manageable than the early stages of decompression. Biportal decompression for spinal stenosis can be performed using an en bloc ligamentum flavum removal technique that is safe, reproducible, and efficient. A systematic approach will help early adopters overcome the steep learning curve.
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