Objective: The unilateral biportal endoscopic (UBE) technique represents the most recent minimally invasive approach to spinal surgery, while microendoscopic discectomy (MED) is a commonly employed surgical intervention. The UBE approach utilizes conventional arthroscopic systems. This study conducted a retrospective analysis of perioperative parameters and clinical outcomes following UBE and MED for the treatment of herniated discs. Methods: This is a retrospective review of data from 65 patients who underwent discectomy for symptomatic herniated nucleus pulposus. These patients were treated between July 2022 and October 2022 with a follow-up of 6 months. Among them, 33 patients underwent the UBE technique, while 32 patients underwent MED. The length of operation time, hospital stays, and time to return to work were compared. Visual analogue scale (VAS) score, the Oswestry Disability Index (ODI), the MacNab score, and complications were evaluated. Results: Five patients were lost to follow-up, leaving 30 patients in each group. Significant improvements were observed in the mean VAS scores for back and leg pain, MacNab scores, and ODI scores in both the UBE and MED groups (p<0.05). At the 1-week postoperative assessment, the UBE group exhibited a significantly greater improvement in back and leg VAS scores. Regarding perioperative parameters, the UBE group had a longer operative time. No statistically significant differences were observed in terms of surgical complications and time to return to work. Conclusion In this study, UBE for single-level discectomy demonstrated comparable clinical outcomes to MED in terms of pain management, functional disability, and patient satisfaction at 6 months. However, UBE showed advantages in terms of better intraoperative visualization, which contributed to fewer complications and less early postoperative back pain.

Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.

Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.

Insomnia is a pervasive and often debilitating sleep disorder that profoundly affects health and overall wellbeing. This comprehensive review focuses on the historical context, clinical significance, diagnostic criteria, investigative methods, and global treatment guidelines for insomnia. Historically, references to insomnia have appeared in ancient Egyptian and Greek texts, but it was not until the 19th century that they were rigorously studied and classified. Notable individuals, including Vincent van Gogh, Franz Kafka, and Marilyn Monroe, have struggled publicly with insomnia, underscoring its widespread nature. The pathophysiology of insomnia is multifactorial, involving physiological, psychological, and environmental factors. Hyperarousal, dysregulation of the sleep-wake cycle, and neurotransmitter imbalances are central to its development. Insomnia can be categorized into acute, chronic, comorbid, idiopathic, and behavioral types. Epidemiological studies have revealed that up to 30% of adults experience insomnia, with a higher prevalence among women, older adults, and those with a lower socioeconomic status. Insomnia is associated with adverse health outcomes, including cardiovascular diseases, metabolic disorders, cognitive impairment, and increased mortality risk. The COVID-19 pandemic has exacerbated insomnia owing to stress and lifestyle changes. Diagnosis involves a comprehensive assessment, including sleep history, physical examination, and objective evaluations, such as polysomnography. Treatment combines pharmacological and non-pharmacological interventions with cognitive behavioral therapy for insomnia as the first-line approach. Pharmacotherapy includes benzodiazepines, non-benzodiazepine hypnotics, antidepressants, melatonin, and orexin receptor antagonists. Guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society emphasize individualized, evidence-based treatment plans to improve sleep quality and overall health.