Comparison of clinical efficacy and safety of biportal versus uniportal endoscopic interlaminar discectomy for lumbar disc herniation
Objective To compare the clinical efficacy and safety of unilateral biportal endoscopy discectomy(UBED)versus percutaneous uniportal endoscopic interlaminar discectomy(PEID)for the treatment of single lumbar disc herniation(sLDH).Methods A retrospective analysis was conducted on 52 patients with sLDH who underwent UBED or PEID at the Affiliated Hospital of Southwest Medical University between January 2022 and June 2023.Surgical parameters,clinical outcomes,and imaging indicators were compared between the two groups.For normally distributed quantitative data,mean±standard deviation was used for representation,while for non-normally distributed data,median(lower quartile,upper quartile)was used for representation.Results No significant difference was observed between the two groups in terms of gender,age,disease duration,affected segments,preoperative Visual Analogue Scale(VAS)scores for low back and leg pain,preoperative Oswestry Disability Index(ODI)scores,preoperative disc height ratio(DHR),or preoperative sagittal rotation angle(SRA)(P＞0.05).All patients successfully underwent surgery.In the UBED group,one case of cerebrospinal fluid leakage and one case of pseudomeningocele syndrome occurred postoperatively.In the PEID group,two cases of pseudomeningocele syndrome occurred postoperatively,and one case of recurrence was observed 1.5 years after surgery.Both groups showed significant improvements in VAS scores for low back and leg pain and ODI scores postoperatively and during follow-up compared to preoperative values(P＜0.05).Significant differences were found between the UBED and PEID groups in terms of operation time[(138.3±28.0)vs.(113.5±34.2)min],intraoperative blood loss[(58.6±24.4)vs.(45.7±20.3)mL],postoperative drainage volume[(48.7±16.9)vs.(30.0±13.4)mL],postoperative ambulation time[3.4(3.0,4.0)vs.2.3(2.0,3.0)d],and VAS scores for low back pain on postoperative Day 1(2.87±0.55 vs.2.24±0.65)(P＜0.05).No significant difference was observed in intraoperative fluoroscopy frequency,VAS scores for leg pain on postoperative Day 1,VAS scores for low back and leg pain 6 months and 1 year after operation,postoperative hospital stay,postoperative complication rates,ODI scores 1 year after operation,DHR 1 year after operation,SRA 1 year after operation,or MacNab evaluation 1 year after operation(P＞0.05).Conclusions Both UBED and PEID are safe and effective treatments for sLDH,with similar complication rates and clinical outcomes.However,PEID demonstrates advantages in reducing soft tissue damage and accelerating perioperative recovery.
万方数据
维普
