Unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation: a retrospective study

Hao-Wei Jiang,Xue-Sheng Jiang,Pan Tang,Yong-Li Wang,Bi-Shui Zhan,Cheng-Dong Chen

doi:10.1186/s13018-022-02929-5

Abstract

BackgroundUnilateral biportal endoscopic discectomy (UBE) is a rapidly growing surgical method that uses arthroscopic system for treatment of lumbar disc herniation (LDH), while percutaneous endoscopic lumbar discectomy (PELD) has been standardized as a representative minimally invasive spine surgical technique for LDH. The purpose of this study was to compare the clinical outcomes between UBE and PELD for treatment of patients with LDH.MethodsThe subjects consisted of 54 patients who underwent UBE (24 cases) and PELD (30 cases) who were followed up for at least 6 months. All patients had lumber disc herniation for 1 level. Outcomes of the patients were assessed with operation time, incision length, hospital stay, total blood loss (TBL), intraoperative blood loss (IBL), hidden blood loss (HBL), complications, total hospitalization costs, visual analogue scale (VAS) for back and leg pain, the Oswestry disability index (ODI) and modified MacNab criteria.ResultsThe VAS scores and ODI decreased significantly in two groups after operation. Preoperative and 1 day, 1 month, 6 months after operation VAS and ODI scores were not significantly different between the two groups. Compared with PELD group, UBE group was associated with higher TBL, higher IBL, higher HBL, longer operation time, longer hospital stay, longer incision length, and more total hospitalization costs. However, a dural tear occurred in one patient of the UBE group. There was no significant difference in the rate of complications between the two groups.ConclusionsApplication of UBE for treatment of lumbar disc herniation yielded similar clinical outcomes to PELD, including pain control and patient satisfaction. However, UBE was associated with various disadvantages relative to PELD, including increased total, intraoperative and hidden blood loss, longer operation times, longer hospital stays, and more total hospitalization costs.

Highlights

Unilateral biportal endoscopic discectomy (UBE) is a rapidly growing surgical method that uses arthro‐ scopic system for treatment of lumbar disc herniation (LDH), while percutaneous endoscopic lumbar discectomy (PELD) has been standardized as a representative minimally invasive spine surgical technique for LDH
Perioperative outcomes and complications Compared with PELD group, UBE group was associated with more Hb loss, more Hct loss, higher total blood loss (TBL), higher intraoperative blood loss (IBL), higher hid‐ den blood loss (HBL), longer operation time, longer hospital stay, longer incision length, and more total hospitalization costs (P < 0.05) (Table 2)
One dural tear occurred in UBE group during disc resection. and this patient was observed for 24 h after surgery with absolute bed rest and adequate fluid infusion

Summary

Introduction

Unilateral biportal endoscopic discectomy (UBE) is a rapidly growing surgical method that uses arthro‐ scopic system for treatment of lumbar disc herniation (LDH), while percutaneous endoscopic lumbar discectomy (PELD) has been standardized as a representative minimally invasive spine surgical technique for LDH. PELD has yielded successful outcomes compared to conventional open or microendoscopic surgery, but has shown advantages in controlling muscular trauma, shortening hospital stay, and maintaining the spinal segment stability [6]. It has been standardized as a representative minimally invasive spine surgical technique for LDH [7]

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