Clinical efficacy comparison of unilateral biportal endoscopic discectomy versus percutaneous endoscopic transforaminal discectomy for lumbar disc herniation

English Keywords:Lumbar disc herniation  Unilateral biportal endoscopic discectomy  Percutaneous endoscopic transforaminal discectomy

English Abstract:

  【Abstract】 Objectives: To compare the short-term clinical outcomes between unilateral biportal endoscopic discectomy(UBED) and percutaneous endoscopic transforaminal discectomy(PETD) in the treatment of patients with single-level lumbar disc herniation(LDH). Methods: A total of 56 patients with single-level LDH undergoing UBED or PETD in our hospital between March 2020 to June 2020 were retrospectively analyzed. The patients were divided into UBED group of 29 cases including 17 males and 12 females(averaged 59.6±10.5 years and 13.5±2.7 months of follow-up) and PETD group of 27 cases including 14 males and 13 females (averaged 60.3±12.3 years and 13.8±2.9 months of follow-up). There were no significant differences in the general data such as age, gender, BMI, and follow-up period between the two groups(P＞0.05). The operative time, number of intraoperative fluoroscopy, blood loss, hemoglobin values, and postoperative complications of the two groups were recorded and compared. The quality of life before operation, 3 days, 3 months and 1 year after operation were evaluated by visual analogue scale(VAS) and Oswestry disability index(ODI). The curative effect was evaluated between the groups by modified MacNab criteria at 1 year after operation. Results: All the patients completed the procedure uneventfully. Comparing with the PETD group, patients in the UBED group had more intraoperative blood loss(25.3±9.7ml vs 49.6±15.6ml, P<0.05) and fewer times of intraoperative fluoroscopy(7.71±1.73 vs 3.35±0.81, P<0.05). There was no significant difference in operative time or postoperative complications between the two groups(P>0.05), nor were there significant differences between the two groups in preoperative and postoperative hemoglobin values or in postoperative hemoglobin reductions(P>0.05). The VAS scores of low back and leg pain and ODI after surgery in both groups were significantly decreased compared with those before surgery(P<0.05), while there was no significant difference in the VAS of low back and leg pain and ODI between the two groups at each time point(P>0.05). The excellent/good rate of modified MacNab criteria at one year after operation was 89.7%(26/29) in the UBED group and 88.9%(24/27) in the PETD group(P=1.000). Conclusions: UBED and PETD were both safe and effective in the treatment of lumbar disc herniation. Comparing with PETD, UBED could achieve similar pain relief and improves patients′ quality of life. Although UBED increased intraoperative bleeding, changes in hemoglobin before and after surgery were comparable in both groups, and UBED was effective in reducing the number of intraoperative fluoroscopies.