Analysis of Clinical and Radiological Outcomes between UBE Procedure and Conventional Open Surgery in the Treatment of Lumbar Disc Herniation

Heng DING; Le HU; You LI; Liang CUI; Fan ZHANG; Xingguo LI

doi:10.12259/j.issn.2095-610X.S20240910

Volume 45 Issue 9

Sep. 2024

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Heng DING, Le HU, You LI, Liang CUI, Fan ZHANG, Xingguo LI. Analysis of Clinical and Radiological Outcomes between UBE Procedure and Conventional Open Surgery in the Treatment of Lumbar Disc Herniation[J]. Journal of Kunming Medical University, 2024, 45(9): 62-69. doi: 10.12259/j.issn.2095-610X.S20240910

Citation:

Heng DING, Le HU, You LI, Liang CUI, Fan ZHANG, Xingguo LI. Analysis of Clinical and Radiological Outcomes between UBE Procedure and Conventional Open Surgery in the Treatment of Lumbar Disc Herniation[J]. Journal of Kunming Medical University, 2024, 45(9): 62-69. doi: 10.12259/j.issn.2095-610X.S20240910

Citation:

Heng DING, Le HU, You LI, Liang CUI, Fan ZHANG, Xingguo LI. Analysis of Clinical and Radiological Outcomes between UBE Procedure and Conventional Open Surgery in the Treatment of Lumbar Disc Herniation[J]. Journal of Kunming Medical University, 2024, 45(9): 62-69. doi: 10.12259/j.issn.2095-610X.S20240910

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Analysis of Clinical and Radiological Outcomes between UBE Procedure and Conventional Open Surgery in the Treatment of Lumbar Disc Herniation

doi: 10.12259/j.issn.2095-610X.S20240910

Dept. of Orthopedics，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2024-03-21
Available Online: 2024-09-03
Publish Date: 2024-09-25

Abstract

Abstract

Objective To compare the clinical efficacy and imaging results of unilateral biportal endoscopic discectomy （UBE） with traditional open surgery for the treatment of lumbar disc herniation. Methods We retrospectively analyzed 84 patients with single-segment lumbar disc herniation admitted to the First Affiliated Hospital of Kunming Medical University from January 2022 to March 2023, 44 cases in the UBE group and 40 cases in the open surgery group, and recorded the patients' age, gender, disc herniation site, operation segment, operation time, intraoperative bleeding, and hospitalization days, respectively. Visual analog scale （VAS） scores were performed preoperatively, 2 days postoperatively, and at follow-up at 1 month postoperatively. Efficacy was evaluated using the modified Macnab Treatment Effectiveness Evaluation Index at 1 month of surgery. The preoperative and postoperative articular process preservation rate and disc height changes were compared between the two groups. Results There were no statistically significant differences between the two groups of patients in terms of age, gender, operative segment and type of disc herniation （P > 0.05）. All patients completed the surgery. Compared with the open group, the UBE group had a shorter operation time, less bleeding, and a shorter postoperative hospitalization （P < 0.05）, and the perioperative complication rate was lower in the UBE group than in the open group （P < 0.05）. The VAS scores of patients in the two groups decreased significantly at preoperation and 2 days postoperation （P < 0.05）, but the difference between the two groups was not significant at 1 month postoperation （P > 0.05）; and the difference in VAS scores at preoperation, 2 days postoperation and 1 month postoperation within the groups was statistically significant （P < 0.05）. The results of the modified Macnab efficacy evaluation criteria in the UBE group were 40, 2, 2 and 0 cases in order of excellent, good, acceptable and poor at the last follow-up, and the overall excellent rate was as high as 95.4%. In the open surgery group, there were 29, 7, 4 and 0 cases of excellent, good, feasible and poor, with an overall excellent rate of 90%. The difference in disc height between the two groups was statistically significant when comparing preoperative and postoperative disc heights （P < 0.05）. For the UBE group, there was no statistically significant difference between the preoperative and postoperative disc heights within the group （P > 0.05）, while the postoperative disc height in the open group was significantly increased compared with that of the preoperative period, with a statistically significant difference （P < 0.05）.The preservation rate of the articular eminence in the UBE group was 63.6%, while the preservation rate of the articular eminence in the open surgery group was 10%. Conclusion UBE can directly reach the target point to release nerve compression, and is a new technique that is minimally invasive, flexible, less traumatic, has a gentle learning curve, has little effect on spinal mobility, and is conducive to postoperative rehabilitation, which can completely remove the protruding nucleus pulposus, and has an ideal clinical therapeutic effect.
- Unilateral biportal endoscopic discectomy,
- Traditional open surgery,
- Lumbar disc herniation,
- Efficacy evaluation

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References(21)

References

[1]	Lindbäck Y,Tropp H,Enthoven P,et al. PREPARE: Presurgery physiotherapy for patients with degenerative lumbar spine disorder: A randomized controlled trial[J]. Spine J,2018,18(8):1347-1355. doi: 10.1016/j.spinee.2017.12.009
[2]	陈洋,赵红卫,王谦. 单侧双通道内窥镜技术治疗腰椎退行性疾病的研究进展[J]. 脊柱外科杂志,2023,21(4):284-288. doi: 10.3969/j.issn.1672-2957.2023.04.013
[3]	Yue J J,Long W. Full endoscopic spinal surgery techniques: advancements,indications,and outcomes[J]. Int J Spine Surg,2015,9:17. doi: 10.14444/2017
[4]	Heo D H,Son S K,Eum J H,et al. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: Technical note and preliminary clinical results[J]. Neurosurg Focus,2017,43(2):E8. doi: 10.3171/2017.5.FOCUS17146
[5]	Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients[J]. J Bone Joint Surg Am,1971,53(5):891-903. doi: 10.2106/00004623-197153050-00004
[6]	Yoon W W,Koch J. Herniated discs: When is surgery necessary?[J]. EFORT Open Rev,2021,6(6):526-530. doi: 10.1302/2058-5241.6.210020
[7]	Zhang Y,Feng B,Hu P,et al. One-hole split endoscopy technique versus unilateral biportal endoscopy technique for L5-S1 lumbar disk herniation: analysis of clinical and radiologic outcomes[J]. J Orthop Surg Res,2023,18(1):668. doi: 10.1186/s13018-023-04159-9
[8]	杨书情,张世民,吴冠男,等. 两种不同入路经皮椎间孔镜技术治疗高位腰椎间盘突出症[J]. 中国骨伤,2020,33(7):7.
[9]	Stanuszek A,Jędrzejek A,Gancarczyk-Urlik E,et al. Preoperative paraspinal and psoas major muscle atrophy and paraspinal muscle fatty degeneration as factors influencing the results of surgical treatment of lumbar disc disease[J]. Arch Orthop Trauma Surg,2022,142(7):1375-1384. doi: 10.1007/s00402-021-03754-x
[10]	Shim H K,Choi K C,Cha K H,et al. Interlaminar endoscopic lumbar discectomy using a new 8.4-mm endoscope and nerve root retractor[J]. Clin Spine Surg,2020,33(7):265-270. doi: 10.1097/BSD.0000000000000878
[11]	Goudman L, Pilitsis JG, Billet B, et al. The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain[J]. Anaesthesia,2024,79(2):128-138.
[12]	Kambin P,Gellman H. Percutaneous lateral discectomy of the lumbar spine: A preliminary report[J]. Clin Orthop Relat Res,1983,174(174):127-132.
[13]	De Antoni D J,Claro M L,Poehling G G,et al. Translaminar lumbar epidural endoscopy: Anatomy,technique,and indications[J]. Arthroscopy,1996,12(3):330-334. doi: 10.1016/S0749-8063(96)90069-9
[14]	Choi K C,Shim H K,Hwang J S,et al. Comparison of surgical invasiveness between microdiscectomy and 3 different endoscopic discectomy techniques for lumbar disc herniation[J]. World Neurosurg,2018,116:e750-e758. doi: 10.1016/j.wneu.2018.05.085
[15]	Kinaci A,Moayeri N,van der Zwan A,et al. Effectiveness of sealants in prevention of cerebrospinal fluid leakage after spine surgery: A systematic review[J]. World Neurosurg,2019,127: 567-575. e1.
[16]	Park H J,Kim S K,Lee S C,et al. Dural tears in percutaneous biportal endoscopic spine surgery: Anatomical location and management[J]. World Neurosurg,2020,136:e578-e585. doi: 10.1016/j.wneu.2020.01.080
[17]	温冰涛,张西峰,王岩,等. 经皮内窥镜治疗腰椎间盘突出症的并发症及其处理[J]. 中华外科杂志,2011,49(12):5.
[18]	Wu B,Zhan G,Tian X,et al. Comparison of transforaminal percutaneous endoscopic lumbar discectomy with and without foraminoplasty for lumbar disc herniation: A 2-year follow-up[J]. Pain Research & Management,2019,2019:1-12.
[19]	Ahn Y,Lee H Y,Lee S H,et al. Dural tears in percutaneous endoscopic lumbar discectomy[J]. Eur Spine J,2011,20(1):58-64. doi: 10.1007/s00586-010-1493-8
[20]	Pfirrmana C W,Metzdorf A,Zanetti M,et al. Magnetic resonance classification of lumbar intervertebral discdegeneration[J]. Spine(Phila Pa 1976),2001,26(17): 1873-1878.
[21]	冯德伟,逄树婷,孙盼,等. 两种手术方式治疗不同Pfirrmann分级腰椎间盘突出症的疗效分析[J]. 中国骨与关节损伤杂志,2022,37(5):458-463. doi: 10.7531/j.issn.1672-9935.2022.05.003

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