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Comparative Study Between Unilateral Biportal Endoscopic Discectomy and Percutaneous Interlaminar Endoscopic
Jianjian Yin1, Gongming Gao1, Senlin Chen1
1Department of Orthopedics, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
Purpose:
To compare the clinical outcomes of unilateral biportal endoscopic discectomy (UBED) and percutaneous interlaminar endoscopic discectomy (PIED) for treating L5/S1 disc herniation.
Methods:
Patients with L5/S1 disc herniation treated with UBED (n = 46) and PIED (n = 50) in our hospital during the same period were retrospectively reviewed. Clinical outcome, radiographic parameters, and complications of each group were collected and evaluated.
Results:
The mean follow-up period was 14.11 ± 3.47 months in the UBED group and 14.52 ± 5.37 months in the PIED group. There was no significant difference in visual analog scale score for the leg (P = 0.836) or lumbar scores (P = 0.335) between PIED and UBED group at preoperative, 1-day postoperative, and last follow-up point. Within the same group, there were significant differences in visual analog scale score for the leg (P < 0.001) and lumbar scores (P < 0.001) compared pairwise at 3 time points. Oswestry Disability Index scores of both groups showed significant improvement at the last follow-up (P < 0.001, P < 0.001), and there was no significant difference in patient satisfaction rates (97.8% vs. 96%) between the 2 groups on the basis of the MacNab criteria. The percentage of facet joint preservation was 96.74 ± 9.10% in the UBED group and 99.22 ± 1.52% in the PIED group. The total blood loss and hospitalization cost was greater in the UBED group. One patient in both groups showed postoperative hematoma. A dural tear occurred in UBED group and a never root injury occurred in the PIED group.
Conclusions:
UBED indicates similar short-term efficacy compared with PIED for treating L5/S1 disc herniation. No difference was found in facet joint preservation between the 2 groups. We believe the increased cost of UBED as the result of surgical consumables will decrease in the future.
