Comparison of the efficacy of unilateral biportal endoscopic and microscopic discectomy in treatment of lumbar disc herniation
- VernacularTitle:单侧双通道内镜技术与显微镜下髓核摘除术治疗腰椎间盘突出症疗效比较
- Author:
Weidong GUO
1
;
Xiaoping ZHANG
1
;
Xiaoming BAO
1
;
Kang YAN
1
;
Huanhuan QIAO
1
;
Haien ZHAO
1
;
Xin DONG
1
;
Bo LIAO
1
Author Information
- Publication Type:Journal Article
- Keywords: unilateral biportal endoscopy; microscopic discectomy; lumbar disc herniation
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(3):430-435
- CountryChina
- Language:Chinese
- Abstract: 【Objective】 To compare the clinical efficacy of unilateral biportal endoscopic （UBE） and microscopic discectomy in the treatment of lumbar disc herniation （LDH） and to explore the safety and effectiveness of this operation. 【Methods】 A total of 87 LDH patients from July 2018 to July 2021 were analyzed retrospectively， including 42 cases of unilateral biportal endoscopic discectomy and 45 cases of microscopic discectomy. Analysis was based on comparison of perioperative metrics， operation time， and estimated blood loss. Clinical outcomes were evaluated using visual analogue scale （VAS）， Oswestry disability index （ODI） and modified Macnab criterion. 【Results】 All patients were followed up for 13.3±1.18 months. In UBE group， operation time （57.12±6.35） min was shorter than that in the microscope group （62.21±7.09） min and estimated blood loss （29.31±3.62） mL was smaller than that in the microscope group （51.77±8.43） mL， with a significant difference （P<0.05）. The two groups of patients had significantly lower back pain VAS score， leg pain VAS score， and ODI index than those before operation （P<0.05）. The VAS score of lower back pain at 3 days after operation and the ODI index at 1 month after operation were significantly lower in UBE group than in the microscope group （P<0.05）. At other time points， there was no significant difference in lower back pain VAS score， leg pain VAS score or ODI index （P>0.05）. Dural sac tear occurred in 2 cases in UBE group and 3 cases in the microscope group； the incidence was not statistically significant （P>0.05）. Modified MacNab criterion evaluation at the last follow-up showed that 32 cases were excellent in UBE group， 7 cases were good， and 3 cases were fair， with the excellent and good rate of 92.9% （39/42）. The microscope group was excellent in 31 cases， good in 10 cases， and fair in 4 cases， with the excellent and good rate of 91.1% （41/45）. 【Conclusion】 UBE for LDH has a satisfactory short-term clinical efficacy， with the advantages of less trauma， greater efficiency， clear vision， and large operating space. Both UBE and microscopic discectomy can achieve good clinical results in treating LDH， but the former has the advantages of less trauma， high efficiency， and quick postoperative recovery.
