Comparison of the mid-long term efficacy on UBE and MED in treating lumbar spinal stenosis
Objective:To compare the mid-long term efficacy of unilateral biportal endoscopic discectomy(UBE)and microendoscopic discectomy(MED)in the treatment of degenerative spinal stenosis(DLSS).Methods:A total of 137 patients with DLSS admitted to the Department of Orthope-dics and Traumatology of the Third Affiliated Hospital of Yunnan University of Chinese Medicine and the First Affiliated Hospital of Yunnan University of Chinese Medicine from September 2018 to Septem-ber 2019 were retrospectively analyzed.They were divided into the UBE group(n =66)and MED group(n =71)based on different surgical methods.The clinical and imaging data of the two groups were compared before,after operation and during follow-up.Results:There were no serious compli-cations in the two groups before,during and after operation,and the patients in the two groups were discharged smoothly.The total length of surgical incision in the UBE group was longer than that in the MED group,and the difference was statistically significant(P＜0.05).There was no significant difference in length of stay and ambulation time between the two groups(P＞0.05).VAS scores of low back pain and leg pain and ODI scores of the two groups decreased significantly with time after op-eration(P＜0.05).VAS scores of low back pain in the UBE group were significantly higher than those in the MED group 7 days after operation,and the difference was statistically significant(P＜0.05).However,there was no significant difference in the above indicators between the two groups 3 months,24 months and 36 months after operation(P＞0.05).There was no significant difference in the area of lumbar spinal canal between the two groups 24 months and 30 months after operation(P＞0.05),but the cross-sectional area of paraspinal muscle and the degree of paraspinal muscle atrophy in the MED group were significantly better than those in the UBE group,and the difference was statisti-cally significant(P＜0.05).There was no significant difference in the incidence of complications be-tween the two groups(P＞0.05).Conclusion:Both UBE and MED have the advantages of smaller incision and less bleeding,but UBE is not superior to MED in the early relief of low back pain,the cross-sectional area of paraspinal muscle in the medium and long term,and the degree of paraspinal muscle atrophy.Meanwhile,the decompression effect of the two surgical methods is similar.There-fore,MED technique is worthy of priority recommendation in the selection of surgical methods for pa-tients with DLSS.
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