Clinical Outcomes of Unilateral Biportal Endoscopy for Intraspinal High-grade Migrated Lumbar Intervertebral Disc Herniation
Objective To evaluate the clinical outcomes of unilateral biportal tendoscopy(UBE)for intraspinal high-grade migrated lumbar intervertebral disc herniation.Methods Totally,22 patients with intraspinal high-grade migrated lumbar intervertebral disc herniation treated by UBE in Zhangzhou Affiliated Hospital of Fujian Medical University from March 2020 to September 2021 were retrospectively analyzed.Visual analogue scale(VAS)of lumbar and leg pain and Oswestry disability index(ODI)were recorded before and 3 months,12 months after operation.The efficacy was evaluated by modified MacNab standard at the last follow-up.The stability and adjacent segment degeneration of the lumbar spine were observed by CT scan 2 days after surgery,MRI and lumbar dynamic radiograph at 3-month follow-up.Results All the 22 patients completed the operation successfully.The operation time was(135.3±2.0)min(120-180 min).All patients were followed up for(16.5±2.0)months(12-23)months.VAS and ODI scores were significantly improved at 3rd and 12th month after surgery(P＜0.05).Two patients had dural rupture after surgery,and all recovered after the symptomatic treatment such as changing position,prolonging extubation time,and preventing infection.One patient experienced discomfort in the lower back during surgery,which was relieved after bed rest and symptomatic medication treatment.At the last follow-up,the modified MacNab criteria were used to evaluate clinical efficacy:excellent in 18 cases,good in 3 cases and fair in 1 case,with an excellent/good rate of 95.45%.No recurrence occurred in this group.Postoperative CT,X-ray and MRI showed no lumbar instability or adjacent segment degeneration.Conclusion UBE in the treatment of intraspinal high-grade migrated lumbar intervertebral disc herniation has satisfactory early clinical outcomes.
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