[OUR EXPERIENCE WITH THE USE OF BIPORTAL ENDOSCOPIC SURGERY IN THE TREATMENT OF HERNIATED DISCS OF THE LUMBAR SPINE]

Open microdiscectomy is the standard surgical treatment for herniated discs at the lumbar level. However, with open operations on the spine, the risk of developing postoperative instability of the spine and the occurrence of chronic back pain is quite high. Biportal endoscopic spinal surgery is a new method in minimally invasive spinal surgery, which has several advantages over open surgery. The aim of the study was to analyze the results of treatment of patients with hernias of the intervertebral discs who underwent biportal endoscopic discectomy and compare them with the results of treatment with open microdiscectomy. The analysis of the results of treatment of 155 patients who underwent a diskectomy operation from March 2019 to October 2019 was performed: 67 patients were operated by biportal endoscopy in the spine surgery clinic of the Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine, while 88 - The first patient was operated on by open microdiscectomy in the Ivano-Frankivsk Regional Clinical Hospital. Pain intensity was assessed using a visual analogue pain scale (VAS), patient satisfaction and quality of life were assessed using a modified MacNab scale and the Oswestry Disability Index (ODI), respectively, 1 week, 3 months and 6 months after surgery. Perioperative data were also evaluated (duration of surgery and length of stay in the hospital, blood loss and complications). X-ray results were evaluated using pre- and postoperative MRI (6-8 weeks after surgery). One week after surgery, the level of VAS back pain in the biportaldiskectomy group showed more significant improvements than in the group after open microdiscectomy. However, the comparative results after a 3-month and 6-month period for VAS (back and leg), ODI questionnaires, a modified MacNab scale, did not significantly differ between the two groups. In the biportaldiskectomy group, the level of blood loss (32.82±15.9) was lower, and the length of hospital stay (2.8±1.6) was shorter than in the group of patients after open microdisectomy (141.1±56.5) and (6.6±1.3), respectively. However, the duration of the operation (71.3±21.9) was longer in the biportal discectomy group than in the group after open microdisectomy (62.2±14.6), the difference was statistically significant. Biportal endoscopic spinal surgery is an effective method for the treatment of hernias of the intervertebral intervertebral discs of the lumbar region, which has several advantages over open surgery, namely: less tissue trauma, less blood loss, faster back pain regression after surgery, higher patient satisfaction with the result of treatment, and reduced hospital stay.