Biportal Endoscopic Technique versus Open Microdiscectomy for Recurrent Lumbar Disc Herniation: A Retrospective...

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Recurrent lumbar disc herniation (RLDH) presents challenges for revision surgery due to scar tissue.
• Open lumbar microdiscectomy (OLM) carries risks like dural tears and nerve damage in revision cases.
• Biportal endoscopic (BE) surgery is a minimally invasive alternative for RLDH management.

Purpose of the Study:

• To compare the outcomes of biportal endoscopic (BE) surgery versus open lumbar microdiscectomy (OLM) for recurrent lumbar disc herniation (RLDH).
• To evaluate postoperative pain, functional recovery, and complication rates between the two surgical techniques.

Main Methods:

• Retrospective review of 82 patients undergoing BE or OLM for RLDH between January 2020 and July 2023.
• Analysis of demographic data, visual analog scale (VAS) pain scores, Oswestry Disability Index (ODI) scores, MacNab scores, and complications.
• Statistical analysis with significance set at p<0.05.

Main Results:

• Both BE and OLM groups showed significant improvements in VAS and ODI scores.
• The BE group reported less early postoperative back pain (p=0.025) and shorter hospital stays (21 vs. 36 hours, p=0.0001).
• The OLM group experienced less postoperative leg pain (p=0.003); complication rates were similar between groups.

Conclusions:

• Biportal endoscopic (BE) surgery is a viable alternative to OLM for RLDH, offering comparable outcomes.
• BE provides advantages of reduced early postoperative back pain and shorter hospital stays.
• Further research with larger cohorts and longer follow-up is recommended to confirm these findings.