Medical comparability of unilateral biportal endoscopic approach versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective evaluation.
J Orthop Surg Res. 2018 Jan 31;13(1):22
Authors: Kim SK, Kang SS, Hong YH, Park SW, Lee SC
BACKGROUND: The unilateral biportal endoscopic (UBE) approach is a minimally invasive process for spinal surgical procedure, whereas open microscopic discectomy is the commonest surgical remedy for ruptured or herniated discs of the lumbar backbone. A brand new endoscopic approach that makes use of a UBE method has been utilized to standard arthroscopic methods for the remedy of spinal illness. On this research, we aimed to match and consider the perioperative parameters and scientific outcomes, together with restoration from surgical procedure, ache and life high quality modification, affected person’s satisfaction, and issues, between UBE and open lumbar microdiscectomy (OLM) for single-level discectomy procedures.
METHODS: This research included 141 sufferers with degenerative disc illness requiring discectomy at a single degree from L2-L3 to L5-S1. A complete of 60 and 81 sufferers underwent UBE and OLM, respectively. Evaluation was primarily based on comparability of perioperative metrics, operation time (OT); estimated blood loss (EBL); size of hospital keep (HS); scientific outcomes, together with evaluation utilizing the Visible Analogue Scale (VAS) and Oswestry Incapacity Index (ODI); affected person satisfaction (the MacNab rating); and the incidence of reoperation and issues.
RESULTS: The research cohort was 56.7% ladies, and the imply affected person age was 50.98?±?18.23 years. The imply VAS (the again and leg), MacNab rating, and ODI improved considerably from the preoperative interval to the final follow-up (12.92?±?Three.92) in each teams (p?<?zero.001). One week after operation, the again VAS rating within the UBE group confirmed considerably extra enchancment than that within the OLM group. Nonetheless, the 1-week, Three-month, and 12-month VAS (the again and leg), ODI enchancment, modified MacNab rating, and OT weren’t considerably totally different between the 2 teams. Within the UBE group, EBL (34.67?±?16.92) was smaller and HS (2.77?±?1.2) was shorter than that of the OLM group (140.05?±?57.eight, 6.37?±?1.39). Nonetheless, OT (70.15?±?22.zero) was longer within the UBE group than within the OLM group (60.38?±?15.5), and the distinction was statistically vital. In the meantime, the variations within the price of surgical conversion and issues between the 2 teams weren’t statistically vital.
CONCLUSIONS: The UBE for single-level discectomy yielded related scientific outcomes to OLM, together with ache management, practical incapacity, and affected person satisfaction, however incurred minimal EBL, HS, and postoperative again ache.
TRIAL REGISTRATION: Not relevant.
PMID: 29386033 [PubMed – in process]