Title：Percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopy in the treatment of L5/S1 degeneration disease: a randomized controlled trial

Abstract

Background: Lumbar degenerative disease(LDD)is a prevalent condition that significantly impairs individuals'quality of life due to the presence of lower back and leg pain symptoms. This retrospective study was designed to compare and analyze the clinical outcomes of percutaneous endoscopic interlaminar discectomy(PEID)and unilateral biportal endoscopy(UBE) in the treatment of LDD. Methods: A total of 79 L5/S1 LDD patients admitted to the Spinal Surgery Department of the First Affiliated Hospital of Chongqing Medical University from September 2020 to May 2023 were selected and divided into Group A(PEID) and Group B(UBE) according to different surgical methods.Basic data, preoperative and postoperative lumbar and leg pain scores (as measured by the visual analogue Scale [VAS]), and functional recovery (as measured by the Dysfunction Index [ODI] score) were assessed for each group.The statistical analysis of the results from both groups was conducted using SPSS 25.0 software. Results: There were significant differences in postoperative lumbar and leg pain scores and functional impairment indexes between the two groups. Lower back pain score 1 day and 1 month after surgery in PEID group was lower than that in UBE group, and leg pain score 1 day, 1 month and 3 months after surgery in PEID group was lower than that in UBE group. The functional impairment index at 1 day, 1 month, 3 months and 6 months after operation in UBE group was lower than that in PEID group, and the difference was statistically significant (P < 0.05). Conclusion: This study suggests that although both approaches are effective in the treatment of L5/S1 degenerative diseases and can relieve back and leg pain and dysfunction, UBE is more advantageous in the treatment of central canal stenosis, and PEID is more effective in the short-term relief of back and leg pain caused by central protrusion. This may provide a basis for patients to make personalized surgical plans.