{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:45:02Z","timestamp":1790783102410,"version":"4.1.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"25","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,6,22]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>During unilateral biportal endoscopic (UBE) lumbar surgery, adhesiolysis can be technically challenging compared with microscopic lumbar surgery because of the constraints imposed by single-handed manipulation. The authors evaluated the use of a scope retractor as an adjunctive tool to facilitate bimanual-like tissue handling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>Two illustrative cases with severe epidural adhesions\u2014one related to postoperative scarring and the other associated with chronic inflammation from a synovial cyst\u2014were treated with the aid of a scope retractor, which was used either to secure adhesive tissue or as a dissecting instrument. Successful adhesiolysis and adequate neural decompression were achieved in both cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>UBE surgery provides high-quality visualization that enhances differentiation between the dura mater and surrounding soft tissue. Incorporation of a scope retractor facilitates precise tissue handling by providing an effect analogous to bimanual manipulation, improving surgical outcomes in cases with severe epidural adhesions.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26223\">https:\/\/thejns.org\/doi\/10.3171\/CASE26223<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26223","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:57Z","timestamp":1782259257000},"source":"Crossref","is-referenced-by-count":1,"title":["Utility of the scope retractor for adhesiolysis in unilateral biportal endoscopic lumbar surgery: illustrative cases"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6264-8617","authenticated-orcid":true,"given":"Changik","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gangnam GIE Hospital, Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Jamsil St. Mary\u2019s Baruda Neurosurgical Clinic, Seoul"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-0875","authenticated-orcid":true,"given":"Jin-Sung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"390","article-title":"Biportal endoscopic lumbar decompression for lumbar disk herniation and spinal canal stenosis: a technical note","volume":"78","author":"Eun","year":"2017","unstructured":"Eun SSEum JHLee SHSabal LA.Biportal endoscopic lumbar decompression for lumbar disk herniation and spinal canal stenosis: a technical note. J Neurol Surg A Cent Eur Neurosurg. 2017;78(4):390-396. doi:10.1055\/s-0036-1592157"},{"issue":"4","key":"bib2","series-title":"J Neurosurg Spine","first-page":"602","article-title":"Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results","volume":"24","author":"Hwa Eum","year":"2016","unstructured":"Hwa Eum JHwa Heo DSon SKPark CK.Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016;24(4):602-607. doi:10.3171\/2015.7.SPINE15304"},{"issue":"4","key":"bib3","series-title":"Clin Orthop Surg","first-page":"439","article-title":"Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis","volume":"10","author":"Kim","year":"2018","unstructured":"Kim JEChoi DJPark EJ.Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis. Clin Orthop Surg. 2018;10(4):439-447. doi:10.4055\/cios.2018.10.4.439"},{"issue":"1","key":"bib4","series-title":"J Orthop Surg Res","first-page":"22","article-title":"Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis","volume":"13","author":"Kim","year":"2018","unstructured":"Kim SKKang SSHong YHPark SWLee SC.Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis. J Orthop Surg Res. 2018;13(1):22. doi:10.1186\/s13018-018-0725-1"},{"issue":"8","key":"bib5","series-title":"Brain Sci","first-page":"516","article-title":"Novel instruments for percutaneous biportal endoscopic spine surgery for full decompression and dural management: a comparative analysis","volume":"10","author":"Hong","year":"2020","unstructured":"Hong YHKim SKSuh DWLee SC.Novel instruments for percutaneous biportal endoscopic spine surgery for full decompression and dural management: a comparative analysis. Brain Sci. 2020;10(8):516. doi:10.3390\/brainsci10080516"},{"key":"bib6","series-title":"Case Rep Orthop","first-page":"4095518","article-title":"Advanced technique of unilateral biportal endoscopy on revision surgery for recurred herniated Interverbral disc: a technical note","volume":"2024","author":"Kim","year":"2024","unstructured":"Kim HCLee JYCho HGPark JWHan SHKo YI.Advanced technique of unilateral biportal endoscopy on revision surgery for recurred herniated Interverbral disc: a technical note. Case Rep Orthop. 2024;2024:4095518. doi:10.1155\/2024\/4095518"},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","first-page":"557","article-title":"Clinical outcome of biportal endoscopic revisional lumbar discectomy for recurrent lumbar disc herniation","volume":"15","author":"Kang","year":"2020","unstructured":"Kang MSHwang JHChoi DJClinical outcome of biportal endoscopic revisional lumbar discectomy for recurrent lumbar disc herniation. J Orthop Surg Res. 2020;15(1):557. doi:10.1186\/s13018-020-02087-6"},{"issue":"2","key":"bib8","series-title":"J Korean Neurosurg Soc","first-page":"231","article-title":"Feasibility of recurrent herniation surgery with biportal endoscopic discectomy: a comparison of biportal endoscopic discectomy and microscopic discectomy for recurrent disc herniation","volume":"69","author":"Han","year":"2026","unstructured":"Han SYLee SHJang JWFeasibility of recurrent herniation surgery with biportal endoscopic discectomy: a comparison of biportal endoscopic discectomy and microscopic discectomy for recurrent disc herniation. J Korean Neurosurg Soc. 2026;69(2):231-237. doi:10.3340\/jkns.2025.0083"},{"issue":"7","key":"bib9","series-title":"Global Spine J","first-page":"1918","article-title":"Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique","volume":"13","author":"Kang","year":"2023","unstructured":"Kang MSPark HJYou KHChoi DJPark CWChung HJ.Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique. Global Spine J. 2023;13(7):1918-1925. doi:10.1177\/21925682211068088"},{"issue":"12","key":"bib10","series-title":"Bioengineering (Basel)","first-page":"1363","article-title":"Future of endoscopic spine surgery: insights from cutting-edge technology in the industrial field","volume":"10","author":"Yuh","year":"2023","unstructured":"Yuh WTLee YSJeon JHChoi I.Future of endoscopic spine surgery: insights from cutting-edge technology in the industrial field. Bioengineering (Basel). 2023;10(12):1363. doi:10.3390\/bioengineering10121363"},{"issue":"2","key":"bib11","series-title":"J Spine Surg","first-page":"438","article-title":"Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis","volume":"6","author":"Pao","year":"2020","unstructured":"Pao JLLin SMChen WCChang CH.Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis. J Spine Surg. 2020;6(2):438-446. doi:10.21037\/jss.2020.03.08"},{"issue":"1","key":"bib12","series-title":"J Orthop Surg Res","first-page":"30","article-title":"Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study","volume":"17","author":"Jiang","year":"2022","unstructured":"Jiang HWChen CDZhan BSWang YLTang PJiang XS.Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res. 2022;17(1):30. doi:10.1186\/s13018-022-02929-5"},{"issue":"1","key":"bib13","series-title":"J Orthop Surg Res","first-page":"547","article-title":"The usefulness and utilisation of Lu\u2019s retractor for unilateral biportal endoscopic discectomy: a retrospective cohort study","volume":"20","author":"Zhang","year":"2025","unstructured":"Zhang QZZhang DWWen HLChen TChen JQLu H.The usefulness and utilisation of Lu\u2019s retractor for unilateral biportal endoscopic discectomy: a retrospective cohort study. J Orthop Surg Res. 2025;20(1):547. doi:10.1186\/s13018-025-05932-8"},{"issue":"4","key":"bib14","series-title":"Asian Spine J","first-page":"587","article-title":"Biportal endoscopic en bloc removal of the ligamentum flavum for spinal stenosis: nuances for the \u201cbutterfly\u201d technique","volume":"18","author":"Park","year":"2024","unstructured":"Park CWOh JY.Biportal endoscopic en bloc removal of the ligamentum flavum for spinal stenosis: nuances for the \u201cbutterfly\u201d technique. Asian Spine J. 2024;18(4):587-593. doi:10.31616\/asj.2024.0057"},{"issue":"1","key":"bib15","series-title":"Acta Neurochir (Wien)","first-page":"182","article-title":"Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy","volume":"166","author":"Kim","year":"2024","unstructured":"Kim JYHeo DH.Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy. Acta Neurochir (Wien). 2024;166(1):182. doi:10.1007\/s00701-024-06076-0"},{"issue":"4","key":"bib1","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"390","article-title":"Biportal endoscopic lumbar decompression for lumbar disk herniation and spinal canal stenosis: a technical note","volume":"78","author":"Eun","year":"2017","unstructured":"Eun SSEum JHLee SHSabal LA.Biportal endoscopic lumbar decompression for lumbar disk herniation and spinal canal stenosis: a technical note. J Neurol Surg A Cent Eur Neurosurg. 2017;78(4):390-396. doi:10.1055\/s-0036-1592157"},{"issue":"4","key":"bib2","series-title":"J Neurosurg Spine","first-page":"602","article-title":"Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results","volume":"24","author":"Hwa Eum","year":"2016","unstructured":"Hwa Eum JHwa Heo DSon SKPark CK.Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. J Neurosurg Spine. 2016;24(4):602-607. doi:10.3171\/2015.7.SPINE15304"},{"issue":"4","key":"bib3","series-title":"Clin Orthop Surg","first-page":"439","article-title":"Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis","volume":"10","author":"Kim","year":"2018","unstructured":"Kim JEChoi DJPark EJ.Clinical and radiological outcomes of foraminal decompression using unilateral biportal endoscopic spine surgery for lumbar foraminal stenosis. Clin Orthop Surg. 2018;10(4):439-447. doi:10.4055\/cios.2018.10.4.439"},{"issue":"1","key":"bib4","series-title":"J Orthop Surg Res","first-page":"22","article-title":"Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis","volume":"13","author":"Kim","year":"2018","unstructured":"Kim SKKang SSHong YHPark SWLee SC.Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis. J Orthop Surg Res. 2018;13(1):22. doi:10.1186\/s13018-018-0725-1"},{"issue":"8","key":"bib5","series-title":"Brain Sci","first-page":"516","article-title":"Novel instruments for percutaneous biportal endoscopic spine surgery for full decompression and dural management: a comparative analysis","volume":"10","author":"Hong","year":"2020","unstructured":"Hong YHKim SKSuh DWLee SC.Novel instruments for percutaneous biportal endoscopic spine surgery for full decompression and dural management: a comparative analysis. Brain Sci. 2020;10(8):516. doi:10.3390\/brainsci10080516"},{"key":"bib6","series-title":"Case Rep Orthop","first-page":"4095518","article-title":"Advanced technique of unilateral biportal endoscopy on revision surgery for recurred herniated Interverbral disc: a technical note","volume":"2024","author":"Kim","year":"2024","unstructured":"Kim HCLee JYCho HGPark JWHan SHKo YI.Advanced technique of unilateral biportal endoscopy on revision surgery for recurred herniated Interverbral disc: a technical note. Case Rep Orthop. 2024;2024:4095518. doi:10.1155\/2024\/4095518"},{"issue":"1","key":"bib7","series-title":"J Orthop Surg Res","first-page":"557","article-title":"Clinical outcome of biportal endoscopic revisional lumbar discectomy for recurrent lumbar disc herniation","volume":"15","author":"Kang","year":"2020","unstructured":"Kang MSHwang JHChoi DJClinical outcome of biportal endoscopic revisional lumbar discectomy for recurrent lumbar disc herniation. J Orthop Surg Res. 2020;15(1):557. doi:10.1186\/s13018-020-02087-6"},{"issue":"2","key":"bib8","series-title":"J Korean Neurosurg Soc","first-page":"231","article-title":"Feasibility of recurrent herniation surgery with biportal endoscopic discectomy: a comparison of biportal endoscopic discectomy and microscopic discectomy for recurrent disc herniation","volume":"69","author":"Han","year":"2026","unstructured":"Han SYLee SHJang JWFeasibility of recurrent herniation surgery with biportal endoscopic discectomy: a comparison of biportal endoscopic discectomy and microscopic discectomy for recurrent disc herniation. J Korean Neurosurg Soc. 2026;69(2):231-237. doi:10.3340\/jkns.2025.0083"},{"issue":"7","key":"bib9","series-title":"Global Spine J","first-page":"1918","article-title":"Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique","volume":"13","author":"Kang","year":"2023","unstructured":"Kang MSPark HJYou KHChoi DJPark CWChung HJ.Comparison of primary versus revision lumbar discectomy using a biportal endoscopic technique. Global Spine J. 2023;13(7):1918-1925. doi:10.1177\/21925682211068088"},{"issue":"12","key":"bib10","series-title":"Bioengineering (Basel)","first-page":"1363","article-title":"Future of endoscopic spine surgery: insights from cutting-edge technology in the industrial field","volume":"10","author":"Yuh","year":"2023","unstructured":"Yuh WTLee YSJeon JHChoi I.Future of endoscopic spine surgery: insights from cutting-edge technology in the industrial field. Bioengineering (Basel). 2023;10(12):1363. doi:10.3390\/bioengineering10121363"},{"issue":"2","key":"bib11","series-title":"J Spine Surg","first-page":"438","article-title":"Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis","volume":"6","author":"Pao","year":"2020","unstructured":"Pao JLLin SMChen WCChang CH.Unilateral biportal endoscopic decompression for degenerative lumbar canal stenosis. J Spine Surg. 2020;6(2):438-446. doi:10.21037\/jss.2020.03.08"},{"issue":"1","key":"bib12","series-title":"J Orthop Surg Res","first-page":"30","article-title":"Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study","volume":"17","author":"Jiang","year":"2022","unstructured":"Jiang HWChen CDZhan BSWang YLTang PJiang XS.Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study. J Orthop Surg Res. 2022;17(1):30. doi:10.1186\/s13018-022-02929-5"},{"issue":"1","key":"bib13","series-title":"J Orthop Surg Res","first-page":"547","article-title":"The usefulness and utilisation of Lu\u2019s retractor for unilateral biportal endoscopic discectomy: a retrospective cohort study","volume":"20","author":"Zhang","year":"2025","unstructured":"Zhang QZZhang DWWen HLChen TChen JQLu H.The usefulness and utilisation of Lu\u2019s retractor for unilateral biportal endoscopic discectomy: a retrospective cohort study. J Orthop Surg Res. 2025;20(1):547. doi:10.1186\/s13018-025-05932-8"},{"issue":"4","key":"bib14","series-title":"Asian Spine J","first-page":"587","article-title":"Biportal endoscopic en bloc removal of the ligamentum flavum for spinal stenosis: nuances for the \u201cbutterfly\u201d technique","volume":"18","author":"Park","year":"2024","unstructured":"Park CWOh JY.Biportal endoscopic en bloc removal of the ligamentum flavum for spinal stenosis: nuances for the \u201cbutterfly\u201d technique. Asian Spine J. 2024;18(4):587-593. doi:10.31616\/asj.2024.0057"},{"issue":"1","key":"bib15","series-title":"Acta Neurochir (Wien)","first-page":"182","article-title":"Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy","volume":"166","author":"Kim","year":"2024","unstructured":"Kim JYHeo DH.Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy. 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