Making exceptional spine care reproducible.Preserve More. Disrupt Less.
Exceptional surgery changes one patient. Reproducible surgery changes healthcare.
Preserve More. Disrupt Less.
Every decision we make begins with one question: Does it help preserve more function by disrupting less tissue?
Progress in spine surgery does not scale through technology alone. It scales when the technique, learning pathway, clinical support, and evidence work as one system. Nexon’s EnSight™ UBE platform brings those elements together to help make tissue-preserving spine care teachable, supportable, and measurable in everyday practice.
Nexon – Shaping UBE in Europe
Nexon is leading the development of UBE in Europe — turning an exceptional surgical technique into a reproducible model for spine care.
Our leadership extends beyond technology. By combining the EnSight UBE platform with structured education, clinical evidence, and long-term implementation support, we help surgeons and hospitals to adopt UBE successfully into their daily practice.
We do not simply participate in the UBE category. We are shaping it.
How do patient outcomes in spine surgery compare to other surgeries?
Despite significant advancements in medical technology and surgical techniques, we understand that there is considerable room for improvement. We therefore endeavour to address the existing challenges and provide innovative solutions to optimize patient care.
Clear performance gap between spine, hip and knee surgery!
A landmark study from the Schulthess Klinik (Zurich, Switzerland), winner of the EUROSPINE 2017 Full Paper Award, measured and compared a patient experience performance indicator – Patient Accepted Symptom State (PASS) – for patients undergoing lumbar spine, hip and knee surgery. Around 90% of hip patients reach an acceptable symptom state after surgery, but only around 45% of patients after lumbar spine surgery.
Full study reference
EUROSPINE 2017 FULL PAPER AWARD: Time to remove our rose-tinted spectacles: a candid appraisal of the relative success of surgery in over 4500 patients with degenerative disorders of the lumbar spine, hip or knee (Mannion et al., Eur Spine J 2018;27:778–788).
A new perspective — the benefits of endoscopic spine surgery
Endoscopic spine surgery — monoportal or biportal — offers patient benefits superior to microsurgery, including low infection risk, minimal pain and fast recovery. Biportal endoscopy (UBE) builds on this with two independent portals — one for high-definition visualization, one for surgical instruments — for excellent visualization and more complex procedures.
20–40%
less post-op pain, endoscopy vs. microsurgery ²
76.3%
shorter hospital stay, endoscopy vs. microdiscectomy ³
29 days
less work absence ⁴
99.9%
less infection rate compared to other non-instrumented spine surgeries ¹
1 Simpson et al., 2021, The Spine Journal · 2 McGrath et al., 2019, JNS · 3 Hasan et al., 2019, JSS · 4 Lokhande et al., 2020, ISJ
Rethinking Spine Surgery
What are key challenges today?
Invasiveness in MIS with related length of hospital stay and recovery time
Despite being labeled “minimally invasive,” many procedures still require relatively wide access corridors.
How can OR-related trauma be reduced to minimize pain, hospital stay and recovery time?
The Learning Curve Challenge
Endoscopic techniques are ultra minimally invasive and powerful—but demanding. Many surgeons face a long learning curve, and traditional training pathways often fall short in building real procedural confidence.
How can a more intuitive transition and safe adoption be enhanced?
Complexity of instruments and sets
Endoscopic procedures frequently rely on specific instruments and disposables that may be less familiar in the usage. Setups are often more complex.
Investment Costs
Microscopes are often a major investment. Monoportal endoscopy may require multiple dedicated instrument sets for different indications, with long and highly specialized tools driving up costs and logistical complexity.
Is there a more versatile and efficient approach that simplifies both instrumentation and economics?
Patient satisfaction
While hip and knee surgery have seen consistently strong outcomes, spine surgery has historically faced greater challenges in patient satisfaction and recovery — a clear need in the treatment of spinal conditions.
How can spine surgery close the satisfaction gap seen in hip and knee outcomes?
Decompression & motion preservation vs. fusion
Achieving effective decompression while preserving natural stability is a constant trade-off — and over-reliance on fusion can limit long-term mobility.
How can effective decompression be achieved while preserving stability and reducing unnecessary fusion?
What if we could leverage the advantages of both worlds?
Open and endoscopic approach — without inheriting their limitations?
- Reducing soft tissue damage for less post-op pain, shorter hospital stay and faster return to work
- Preserving spinal stability and thus delaying spinal disease progression
- Using standardized, familiar and versatile instruments
- Facilitating intuitive handling and improved workflow efficiency
- Reducing the learning curve
- Offering a cost-effective solution
What UBE / Biportal
Endoscopy changes
Two portals – one tissue-preserving approach
UBE uses separate portals for visualization and instrumentation. This concept gives the surgeon independent working channels while preserving familiar surgical principles. This opportunity is larger than a technique: It is the foundation for a reproducible approach to tissue-preserving spine care.
How Nexon makes the position real
Technology
EnSight UBE brings together visualization, instruments, and workflow elements designed for UBE practice.
Mastery
A structured learning pathway supports deliberate practice, mentored cases, whole-team learning, and progression toward independent use.
Evidence
Published literature, data, and a growing clinical network build the proof behind reproducibility.
How does UBE compare to other surgical approaches?
| Microscopic | Monoportal (FESS) | Biportal (UBE) | |
|---|---|---|---|
| Visualization | Microscope | Endoscope (single portal) | Continuous HD endoscopy, independent view |
| Soft-tissue trauma | Higher | Low | Low – muscle-sparing corridor |
| Indication range | Broad | Mainly herniation | Herniation, stenosis, instability, fusion |
| Instrument familiarity | Familiar | Specialized, dedicated sets | Familiar, versatile, standardized |
| Investment | High (microscope) | Multiple dedicated sets | One versatile platform |
More: detailed comparison
| Microsurgery (MIS with tube and microscope) | Monoportal Endoscopy | Biportal Endoscopy (UBE) | |
|---|---|---|---|
| Indications | All types of discectomy, stenosis, to short construct fusion; from lumbar to cervical. | Mainly simple lumbar discectomy. | The same as microsurgery. |
| Visualization | Limited to a single and fixed orientation with a view from far above. Instruments obstruct vision. | Limited to a single port through which instruments are guided. Instruments may obstruct vision. | Camera moves independently to visualize the surgical site and instrument tips. Fusion possible under visualization. |
| Instruments | Large choice of instrument types and sizes. | Long and very thin instruments to enter the small-diameter shafts. | Same size as microscopic surgery – same efficacy. |
| Maneuverability | Unlimited up-down instrument movement, but inclination is restricted by the MIS tube. | Room for maneuverability limited to the endoscopic shaft. | Higher than microscopic surgery due to absence of tube and skin elasticity. |
| Invasiveness | One small incision; tissues are distracted during the entire surgery time. | One small incision. | Two small incisions. Tissue-preservation approach. |
| Surgical time | Highly variable depending on the patient pathologies, hospital setup and surgeon. | Faster than biportal for interlaminar or foraminal simple hernia, as no bone needs to be drilled. | Faster than monoportal for complex hernia, stenosis and fusion due to instrument size. |
| Learning curve | Current standard technique, learned during a long and progressive process during fellowship/residency. | Longer learning curve, easier for surgeons with experience in other monoportal surgeries. | Shorter than monoportal, especially for surgeons with experience in arthroscopy. |
| Investment | Highly expensive microscope, plus tube retractor and instrument set. | Several sets for different accesses and target areas. Specific drills and generator needed. | Economic solution: one single set for all indications. |
Endoscopic Spine Surgery will set new standards.
Current approaches often force a trade-off between invasiveness, precision, efficiency, and usability. What if we could combine the advantages of endoscopy with a more intuitive, versatile, and workflow-friendly approach? The Biportal Endoscopy (UBE) approach offers a compelling solution.
“The biportal endoscopy technique is relatively simple to adopt, as it relies on a more familiar approach, requires less expensive instruments, has a shorter learning curve, and is also well-suited for interbody fusion.”
What’s in it for me?
Nexon supports every stakeholder in the shift to biportal endoscopy — find the path that fits you.
Latest News
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Read more →: When does an emerging technique become a body of evidence?
At EUROSPINE, Dr. François Lechanoine takes a concise look at what the growing UBE literature actually tells us — and where important questions still remain. UBE 2030 | 8 October | 12:30–13:30 | Room A2.
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Read more →: What changes when the camera and the instrument no longer share the same portal?
At EUROSPINE, Dr. Guillaume Lonjon explores the architectural principles behind biportal endoscopy — what two-portal architecture makes possible, today and tomorrow. UBE 2030 | 8 October | EUROSPINE Gothenburg | 12:30–13:30 | Room A2.
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Read more →: Where will your MIS practice be in five years?
At EUROSPINE 2026, Nexon Medical looks beyond the first endoscopic cases and asks what comes next. Five surgeons. Five perspectives. One lunch hour. UBE 2030 | 8 October | EUROSPINE Gothenburg | 12:30–13:30 | Room A2.
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Read more →: How far can UBE go?
PD Dr med. Antonio Faundez (Hôpital de La Tour, Switzerland) on the versatility of UBE: “The versatility of this technique is truly amazing. I honestly don’t see any limits yet.” UBE — defined by reproducible, tissue-preserving spine care.
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Read more →: The real story of UBE is no longer just the learning curve
From disc herniation to stenosis to advanced indications — how UBE is evolving into a scalable surgical category, and why overcoming the “Valley of Tears” (cases 2–8) takes a full ecosystem: technology, education, mentorship, clinical evidence and community.
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Read more →: NSpine Bastia: Endoscopy Is Here to Stay
More than 200 spine surgeons from across Europe and beyond came together in Bastia to discuss the future of minimally invasive and endoscopic spine surgery. The energy and momentum of these days were tangible – a field in motion. One message…
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Read more →: ESUBE 2026: A Community Shaping the Future of Biportal Endoscopy
Some congresses inform. Some are well organized. And some stay with you. ESUBE 2026 was one of those rare meetings where discussions went beyond presentations. Surgeons openly shared experience, challenged ideas constructively, and pushed the…
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Read more →: Nexon at DWG 2025: A Look Back at Three Inspiring Days
DWG 2025 in Wiesbaden was nothing short of extraordinary. From December 10–12, Nexon Medical proudly showcased how Biportal Endoscopy (UBE) is revolutionizing minimally invasive spine surgery. Surgeons, innovators, and thought leaders came…
