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

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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.

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

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

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)

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