Outcomes of patient with lumbar disc herniation undergoing unilateral biportal endoscopic surgery

Abstract

BackgroundUnilateral biportal endoscopic (UBE) surgery for the treatment of lumbar disc herniation (LDH) has been growing rapidly for a relatively short period of time. This minimally invasive surgical technique has achieved favorable results in some developed countries. In the present study, we reported the preliminary outcomes of patients with LDH treated with UBE discectomy in a limited resources institution. MethodsClinical and radiographic data of 46 patients of LDH treated between July 2022 and March 2023 using UBE discectomy techniques including ipsilateral interlaminar approach, contralateral sublaminar approach and paraspinal approach, were reviewed. Outcomes were analyzed in view of modified-Macnab criteria, Japanese Orthopedic Association score (JOA), Visual analog scale (VAS) with a mean follow-up of 3.1 months. ResultsAt the final follow-up, the mean VAS for low back pain was improved from 4.2 ± 1.1 to 1.4 ± 0.3 and VAS for leg pain was improved from 7.9 ± 1.2 to 2.6 ± 0.4. The mean JOA score improved from 13.8 ± 5.2 to 24.4 ± 4.3. Modified Macnab criteria were excellent in 30 patients (65.3 %), good in 14 (30.4 %), fair in 2 (4.3 %). A total of 57 levels of LDH were done. L4-L5 disc herniation was performed in 30 patients (52.6 %), L5-S1 in 20 (35.1 %), L2-L3 in 4 (7.0 %), and L3-L4 in 3 (5.3 %). Ipsilateral approach technique was performed at 48 patients (84.2 %), contralateral sublaminar approach in 7 (12.3 %), and paraspinal approach in 2 (3.5 %). Complications included 2 patients with dural tears (4.3 %), and 1 epidural hematoma (2.2 %). ConclusionsUBE discectomy techniques may be performed safely and effectively for the treatment of LDH in limited resources hospitals.