
Medically Reviewed By
Dr. Deepak Garg ( Orthopaedic Oncology & Robotic Joint Surgery)
A state-of-the-art orthopaedic spine surgery guide detailing Percutaneous Endoscopic Lumbar Discectomy (PELD) and Unilateral Biportal Endoscopy (UBE), comparing transforaminal and interlaminar approaches for lumbar canal stenosis and disc prolapse with zero bone destruction.
CRITICAL CLINICAL RED FLAG: Sudden onset of saddle anesthesia (numbness in the groin/perineal region), loss of bowel or bladder control, or progressive foot drop (loss of ankle dorsiflexion) indicates Cauda Equina Syndrome and requires emergency decompressive surgery within 24 hours.
Lumbar disc herniation and degenerative canal stenosis cause severe radiculopathy (sciatica) and neurogenic claudication. Traditional open microdiscectomy requires muscle stripping, bone resection, and retraction of the dural sac. Full-endoscopic spine surgery eliminates muscle trauma entirely.
Pencil-Thin Optical Port: High-definition 4K endoscope inserted through a 7 to 8 mm skin incision under continuous irrigation.
Zero Muscle Stripping: Dilators split muscle fibers rather than cutting or detaching paraspinal attachments.
Preserves Facet Joints: Protects native segmental biomechanics, virtually eliminating post-operative mechanical low back pain.
Surgical route selection is tailored precisely to the anatomical location of the disc fragment:
Transforaminal (PELD): Direct trajectory through Kambin's triangle under local anesthesia for foraminal, extraforaminal, and L1-L4 central disc herniations.
Interlaminar (PEID): Ideal for L5-S1 herniations where the high iliac crest obstructs a lateral transforaminal pathway.
Unilateral Biportal Endoscopy (UBE / ULBD): Uses two separate 5 mm ports for bilateral decompression of severe central canal stenosis from a unilateral approach.
"Full-endoscopic spine surgery utilizes a 7mm pencil-sized camera port with continuous saline irrigation, removing herniated disc fragments while leaving spinal stabilizing ligaments and facet joints 100% untouched." — Dr. Deepak Garg

Continuous saline fluid irrigation tamponades epidural venous bleeding, provides crystal-clear visualization of the traversing nerve root, and minimizes surgical site infection rates to near zero (<0.1%).
CLINICAL CAUTION: Traditional extensive laminectomies remove substantial stabilizing facet joint bone, predisposing patients to secondary spinal instability and requiring metal fusion screws.
Patients are mobilized out of bed within 2 hours post-surgery and typically discharged on the same evening or following morning with minimal need for oral opioids.
1. Full-endoscopic versus open discectomy for lumbar disc herniation: A randomized controlled trial — Spine, 2021; 46(12): 785-794.
2. Unilateral biportal endoscopic decompression for lumbar spinal stenosis: Technical note and surgical outcomes — World Neurosurg, 2022; 158: e450-e459.

Senior Consultant & Clinical Director — Orthopaedic Oncology & Robotic Joint Surgery
MBBS (TNMC Mumbai), DNB Orthopaedics (PGI & SP Miraj), Fellowship Arthroplasty and Arthroscopy (Fortis Hospital, New Delhi), Fellowship Orthopaedic Oncology (Rajiv Gandhi Cancer Institute, New Delhi)

16+ Years Experience
Spica — Grover Hospital
Request a priority OPD appointment or second opinion on your scans.
Proprietary surgical methodologies and precision protocols pioneered by our senior directors to minimize trauma, protect natural anatomy, and accelerate recovery.

Dr. Deepak Garg (Orthopaedic Surgical Oncology - RGCI Delhi Trained) and Dr. Neha Gupta (Medical Oncology) co-lead the Bone Cancer & Sarcoma Center at Spica Healthcare. Integrating intensive multi-agent neoadjuvant chemotherapy protocols (MAP: High-Dose Methotrexate, Doxorubicin, Cisplatin for Osteosarcoma; VIDE: Vincristine, Ifosfamide, Doxorubicin, Etoposide for Ewing Sarcoma) with 3D computer-navigated limb salvage surgery and modular titanium megaprosthetic joint reconstruction, 5-year survival rates exceed 75% to 80% while saving over 95% of patients from limb amputation.
Spica Healthcare — Bone and Cancer Institute, Bathinda — is South-Western Punjab's premier super-speciality centre led by AIIMS and Tata Memorial fellowship-trained directors.
Every diagnostic MRI review, surgical staging, and operation is personally directed by chief clinical specialists — Dr. Deepak Garg (Orthopaedic Oncology & Robotics) and Dr. Neha Gupta (Medical Oncology) — guaranteeing zero junior proxies.
Sub-millimeter implant positioning and soft-tissue ligament balancing ensuring patients walk comfortably within 24 hours of total knee replacement.
South-West Punjab's only dedicated centre for modular titanium megaprosthesis, saving natural limbs and functions in 95%+ of bone cancer patients.
Full cashless coverage for Ayushman Bharat (PM-JAY), Punjab Govt Health Schemes, ECHS, and 30+ private insurance networks with on-desk approvals.
Positive-pressure HEPA filtered theatres minimizing infection rates below international benchmarks with 24/7 dedicated critical care backup.
Fellowship-trained surgical directors from AIIMS & Tata Memorial providing compassionate, world-class tertiary care in super-speciality orthopaedics and medical oncology.

Senior Consultant & Clinical Director — Medical Oncology
MBBS (BFUHS Faridkot), MD Radiation Oncology (BFUHS Faridkot), DrNB Medical Oncology (Sarvodaya Hospital, Faridabad), Precision Oncology (Harvard, USA), Ex Consultant RGCI New Delhi


Senior Consultant & Clinical Director — Orthopaedic Oncology & Robotic Joint Surgery
16+ Yrs ExpSenior Consultant & Clinical Director — Orthopaedic Oncology & Robotic Joint Surgery
MBBS (TNMC Mumbai), DNB Orthopaedics (PGI & SP Miraj), Fellowship Arthroplasty and Arthroscopy (Fortis Hospital, New Delhi), Fellowship Orthopaedic Oncology (Rajiv Gandhi Cancer Institute, New Delhi)
Free OPD screening camps, director-led masterclasses, and national oncology representations by Spica Healthcare.
Real stories from patients who recovered through limb preservation surgery, 3D robotic joint replacements, and precision cancer care at Spica Healthcare — Grover Hospital, Bathinda.
Evidence-based surgical recovery roadmaps, robotic joint protocols, and precision oncology insights written by our clinical directors.