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

Abstract

Background Unilateral 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. Methods The 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. Results The 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. Conclusions Application 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.

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

“…Three studies [ 16 – 18 ] reported preoperative VAS of back pain between UBE and PELD (134 patients, 64 in the UBE group and 70 in the PELD group). Meta-analysis showed no statistically significant difference in preoperative VAS of back pain between the two groups (WMD = −0.24, 95% CI (-0.57, 0.10), P = 0.16, heterogeneity: Tau 2 = 0.00, χ 2 = 0.00, df = 2 ( P = 1.00), I 2 = 0%).…”

“…Three studies [ 16 – 18 ] reported VAS of leg pain between UBE and PELD preoperatively, 3 days postoperatively, and 30 days postoperatively (134 patients, 64 in the UBED group and 70 in the PELD group). Meta-analysis showed that the difference in VAS of leg pain between the two groups preoperatively was not statistically significant (WMD = −0.10, 95% CI (-0.42, 0.22), P = 0.54, heterogeneity: Tau 2 = 0.00, χ 2 = 0.54, df = 2 ( P = 0.76), I 2 = 0%); the difference in VAS of leg pain at postoperative 3 days was not statistically significant (WMD = 0.21, 95% CI (-0.20, 0.61), P = 0.33, heterogeneity: χ 2 = 0.08, df = 1 ( P = 0.77), I 2 = 0%); the difference in VAS of leg pain at 30 days postoperatively was not statistically significant (WMD = 0.09, 95% CI (-0.29, 0.46), P = 0.65, heterogeneity: Tau 2 = 0.04, χ 2 = 2.96, df = 2 ( P = 0.23), I 2 = 32%).…”

“…Three studies [ 16 – 18 ] reported the ODI score of UBE and PELD at preoperative and postoperative 30 days (134 patients, 64 in the UBED group and 70 in the PELD group). Meta-analysis showed that the difference in preoperative ODI score between the two groups was not statistically significant (WMD = 0.32, 95% CI (-1.91, 2.55), P = 0.78, heterogeneity: χ 2 = 0.61, df = 2 ( P = 0.74), I 2 = 0%); the difference in ODI score at 30 days postoperatively was not statistically significant (WMD = −0.81, 95% CI (-3.03, 1.41), P = 0.47, heterogeneity: χ 2 = 0.10, df = 2 ( P = 0.95), I 2 = 0%); UBE and PELD have similar efficacy in short-term functional recovery ( Figure 6 ).…”

“…The development of endoscopic technology is conducive to the reduction of tissue damage, mainly including microendoscopic discectomy, PELD, and UBE technology [ 30 ]; in particular, UBE has developed rapidly in recent years. UBE and PELD are both minimally invasive surgery, but UBE technology has the incomparable advantages of PELD; independent dual channel makes the operation more flexible, facilitate full decompression, higher safety, and wider surgical indications [ 16 , 18 ]. Therefore, we conducted this meta-analysis to determine whether the short-term efficacy of UBE is better than that of PELD in the treatment of ssLDH.…”

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

“…The study selection flow chart is shown in Figure 1. The 16 eligible articles (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) included 19 comparison groups, with a combined 653 patients who underwent UBE, 612 who underwent MED, 153 who underwent PELD, and 70 who underwent PLIF. Of the 16 included articles, 2 were RCTs, 5 were cohort studies, and 9 were case-control studies.…”