Advantages of 12° Endoscope in Unilateral Biportal Endoscopic Surgery for Lumbar Disc Herniation

Objective This study introduces the application of a 12° endoscope in unilateral biportal endoscopic (UBE) decompression surgery for lumbar disc herniation and discusses its advantages in UBE procedures. Methods From December 2019 to December 2020, 75 patients (33 men and 42 women) were treated with UBE decompression using a 12° endoscope. Patient ages ranged from 26 to 78 years (mean 53.2). Pre- and postoperative visual analog scale (VAS) scores for low back and leg pain were recorded. Surgical outcomes were evaluated using MacNab criteria, with operative time and complications documented. Results The 12° endoscope demonstrated superior maneuverability with a distortion-free visual field. Compared with 30° endoscopes, it showed better applicability within the anatomical working triangle while providing broader visualization than 0° endoscopes. This enabled effective decompression of the superior articular process medial edge, nerve root canal, and lateral recess. Low back pain VAS scores decreased from 7.3 ± 1.3 to 1.9 ± 1.2 (P < 0.001), while leg pain scores improved from 8.1 ± 1.8 to 1.6 ± 1.0 (P < 0.001). At the 12-month follow-up, MacNab criteria outcomes were excellent in 65.3%, good in 25.3%, and unsatisfactory in 9.3% of cases (χ² test, P = 0.002). Conclusion The 12° endoscope demonstrates clinical value as a feasible, safe, and effective option for UBE surgery in lumbar disc herniation treatment. Clinical Relevance Key clinical advantages of the 12° endoscope include direct visualization of key anatomical structures, minimized bone resection (particularly at the medial spinous process base), and a reduction in instrument crowding. These technical benefits contribute to effective decompression, improved patient outcomes (as measured by VAS and MacNab criteria), and potentially a shorter learning curve for surgeons adopting the UBE technique. Level of Evidence 3.