Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation

Abstract

Background

As the latest endoscopic spine surgery, percutaneous endoscopic interlaminar discectomy (PEID) and unilateral biportal endoscopic (UBE) discectomy have distinct technical characteristics. This study aimed to evaluate the clinical outcomes of PEID and UBE discectomy in the treatment of single-level lumbar disc herniation (LDH).

Methods

Between February 2019 and April 2022, 115 patients with single-level LDH at L4-5 or L5-S1 received PEID or UBE discectomy. The patients were separated into two groups based on the surgical method used: Group 1 (the PEID group) (n = 60) and Group 2 (the UBE group) (n = 55). Various parameters, including operative time, hospitalization time, fluoroscopy frequency, total costs, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI), were evaluated and compared between the two groups.

Results

There were no significant differences in the VAS and ODI scores in 12 months after the operation between two groups (P > 0.05). However, the VAS of lower back pain on the first day after the operation in Group 2 (2.53±0.89) was higher than that in Group 1 (2.19±0.74) (P < 0.05). There were no significant differences in the operation time and incidence of complications between two groups (P > 0.05). But total costs in Group 2 (43,121±4280) were significantly higher than those in Group 1 (30,069±3551) (P < 0.05).

Conclusion

Both UBE and PEID procedures have similar efficacy in alleviating pain and improving functional ability in patients with LDH. However, UBE surgery results in higher costs than PEID surgery.

Keywords:

• unilateral biportal endoscopic discectomy
• percutaneous endoscopic interlaminar discectomy
• lumbar disc herniation

Abbreviations

PEID, percutaneous endoscopic interlaminar discectomy; UBE, unilateral biportal endoscopic; ASA, American Society of Anesthesiologists.

Data Sharing Statement

The authors will allow the sharing of participant data. The data will be available to anyone who wishes to access them for any purpose. The data will be accessible from immediately the following publication to 6 months after publication, and contact should be made via the first author by email.

Ethics Approval and Consent to Participate

This study was approved by the clinical research ethics committee of Shannxi Provincial People’s Hospital (No. 2021-018). This study followed the Good Clinical Practice guidelines and the guidelines of the Helsinki Declaration. Written informed consent was obtained from all individual participants included in the study.

Acknowledgment

The authors would like to thank all the study participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Innovation Ability Strong Base Plan-Medical Research Project of Xi’an Science and Technology Bureau in 2022 (No.: 22YXYJ0155).