Unilateral Biportal Endoscopic Annular Repair Using an All-Inside Meniscus Repair Device: A Technical Demonstration, Case Report, and Narrative Review

Recurrent lumbar disc herniation remains a clinically important cause of unsatisfactory outcomes after discectomy, and annular defect size is a major risk factor. Large annular defects >6 mm have been associated with substantially higher recurrence rates after minimally invasive discectomy. This study reviews current evidence on annular repair during endoscopic lumbar discectomy and demonstrates a step-by-step surgical technique using unilateral biportal endoscopy (UBE). A narrative review was conducted to synthesize the literature on recurrent lumbar disc herniation, annular defect characteristics, and repair techniques in endoscopic spine surgery. In addition, an operative video demonstrates annular repair performed via the UBE approach in a clinical case. Annular repair during endoscopic lumbar discectomy is a feasible adjunctive technique that may reduce recurrence in appropriately selected patients.