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Short-Term Clinical Outcomes and Safety of Microendoscope Discectomy and Unilateral Biportal Endoscopic Discectomy
Objective:
To compare the short-term clinical efficacy and safety of unilateral biportal endoscopic discectomy (UBED) and microendoscope discectomy (MED) in the treatment of lumbar disc herniation (LDH).
Study Design:
A descriptive study. Place and Duration of the Study: Department of Orthopaedics, the Second Hospital of Shijiazhuang, Hebei, China, from January 2020 to December 2022.
Methodology:
A total of 160 patients with LDH were divided into two groups: the UBED group (n = 80) and the MED group (n = 80), according to the operation carried out. Data were collected on operation time, hospital stay, blood loss, changes in C-reactive protein (CRP), intraoperative x-ray times, complications, modified MacNab criteria, Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS) scores for low back and leg pain to compare the treatment efficacy and safety between the two groups. An independent samples t-test was used to analyse continuous variables, and the chi-square test was used to assess the categorical variables.
Results:
There was no significant difference in blood loss (p = 0.168), intraoperative x-ray times (p = 0.084), or complication rates between the two groups (p = 0.844). Similarly, there was no significant difference in the VAS and ODI scores at 3, 6, and 12 months postoperatively (all p >0.05). The VAS scores for low back pain in the MED group were higher than that in the UBED on the first postoperative day (p <0.001). In terms of the modified MacNab criteria, there was no significant difference in clinical outcomes between the groups after surgery (p = 0.312). The operation time for the MED group was shorter than that for the UBED group (p <0.001). The length of hospital stay in the MED group was longer (p <0.001). Additionally, changes in CRP levels before and after operation in the UBED group were more significant than that in the MED group (p <0.001).
Conclusion:
The clinical efficacy and safety of the two processes were similar for the treatment of LDH. The operation time of the MED group was shorter than that of the UBED group; however, the length of the hospital stay was longer. UBED could relieve the symptoms of low back pain earlier, but it was more invasive than MED.
Key Words:
Minimally invasive method, Lumbar disc herniation, Unilateral biportal endoscopic discectomy, Microendoscopic discectomy.
