One-hole split endoscopy technique versus unilateral biportal endoscopy technique for L5-S1 lumbar disk herniation: analysis of clinical and radiologic outcomes

Abstract

Background Lumbar disk herniation (LDH) is one of the most common diseases of the spine, especially occurring in L4-5 and L5-S1 intervertebral disks, and surgery is a choice when conservative treatment is ineffective. The purpose of this study is to investigate the clinical efficacy and radiologic outcomes of one-hole split endoscopy (OSE) technique versus unilateral biportal endoscopy (UBE) technique in the treatment of L5-S1 lumbar disk herniation (LDH). Methods A total of 133 patients of a single center surgically treated for L5-S1 LDH between 2019 and 2021 were retrospectively included in this study, of which 70 were treated by UBE technique and the rest were treated by OSE technique. Hospitalization time, operative time, intraoperative blood loss, fluoroscopy times, incision length and related complications were recorded. Bone resection area (BRA), articular process resection rate, range of motion (ROM), sagittal translation (ST), disk height (DH), Visual Analog Score (VAS), Oswestry Disability Index (ODI) and Macnab criteria were used to evaluated the clinical efficacy. Results There was no statistically significant difference in hospitalization time or fluoroscopy times between the two groups. The operation time was shorter in the UBE group than that in the OSE group; however, the incision length was longer. Intraoperative blood loss and BRA were larger in the UBE group than in the OSE group. There was no significant difference in ROM, ST, DH, or postoperative facet resection rate between the two groups. There was no significant difference in ROM, ST, or postoperative facet resection rate compared with preoperative indicators in each group, but there was a significant difference in DH among distinct groups. At any time point, the lower back and leg VAS and ODI in each group were significantly improved compared to those before the operation, with no significant difference between the two groups. There was one case of dural tear in the UBE group. One case of transient hypoesthesia occurred in each of the two groups. The excellent–good rates of the UBE group and the OSE group were 88.6% and 90.5%, respectively. Conclusion The OSE technique is an effective minimally invasive surgical option as well as the UBE technique in the treatment of L5-S1 LDH.

One-hole split endoscope versus unilateral biportal endoscopy for lumbar spinal stenosis: a retrospective propensity score study

“…The OSE technique is an innovative advancement based on the UBE technique and a continuation of coaxial endoscopy, demonstrating new clinical advantages. Like the UBE technique, the OSE consists of working and observation channels; however, these two channels are located within the same soft incision, allowing independent and free operation of the endoscope and instruments through a single port [ 9 ]. The OSE technique also imposes no surgical instrument-related limitations and keeps similar advantages to the UBE technique, such as flexible operation, a wide field of view, and efficient decompression.…”

“…Like the UBE technique, the OSE consists of an observation and a working channel. Compared with the UBE technique, two channels in the OSE are located within the same soft incision, allowing independent and free rotation and swinging without the limitations of fixed channels [ 9 , 10 ]. It does not have the limitation of forming a “V” angle, and the working and observation channels cooperate more effectively in the same direction, with fewer visual blind spots.…”

Comparison of one-hole split endoscopic discectomy and microendoscopic discectomy in the treatment of lumbar disk herniation: a one-year retrospective cohort study

“…One-hole split endoscopy (OSE) is a new endoscopic surgery technique first proposed and applied by Professor Tengyue Zhu in 2019 [ 9 , 10 ]. OSE technology has both working and observation channels, but both are located in the same incision, and each channel can move freely.…”