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Title: [Comparison of effectiveness of unilateral biportal endoscopy technique and the interlaminar uniportal endoscop technique for treatment of L ₅, S ₁ lumbar disc herniation].
Author: Zuo R, Ma M, Jiang Y, Yuan S, Li J, Liu C, Zhang J.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2022 Oct 15; 36(10):1192-1199. PubMed ID: 36310454.
Abstract:
OBJECTIVE: To compare the effectiveness of unilateral biportal endoscopy (UBE) technique with the interlaminar uniportal endoscopy (IUE) technique for the treatment of L ₅, S ₁ lumbar disc herniation. METHODS: The clinical data of 69 patients with L ₅, S ₁ lumbar disc herniation who met the selection criteria between January 2020 and December 2020 were retrospectively analysed. The patients were divided into UBE group (30 cases) and IUE group (39 cases) according to endoscopic surgical technique. The general data, such as gender, age, body mass index, disease duration, and preoperative visual analogue scale (VAS) scores of low back/leg pain and Oswestry disability index (ODI), was not significantly different between the two groups ( P>0.05). Perioperative outcomes [estimated blood loss (EBL), total operation time, extracanal operation time, intracanal decompression time, intraoperative radiation exposure dose, incision length, operative related complications, and postoperative hospitalization stay] and clinical outcomes (VAS score of low back/leg pain before operation and at 3 days, 3 months, 6 months, and 12 months after operation as well as the ODI before operation and at 3 months, 6 months, and 12 months after operation) were recorded and compared between the two groups. RESULTS: All patients completed the surgery successfully. The incision length, EBL, and extracanal operation time in UBE group were significantly longer than those in IUE group ( P<0.05), and the intracanal decompression time in UBE group was significantly shorter than that in IUE group ( P<0.05). There was no significant difference in the total operation time, intraoperative radiation exposure dose, and postoperative hospitalization stay between the two groups ( P>0.05). Patients in both groups were followed up 12-15 months (mean, 13.3 months). Dural tear ocurred in 1 patient of the UBE group, and recurrence ocurred in 1 patient of the IUE group, the others of both groups had no surgery-related complications and recovered well after operation. The VAS scores of low back/leg pain and ODI in both groups at each time point after operation significantly improved when compared with those before operation ( P<0.05); there was no significant difference in VAS scores and ODI at each time point after operation between two groups ( P>0.05). CONCLUSION: The effectiveness of UBE technique in the treatment of L ₅, S ₁ lumbar disc herniation is similar to that of IUE technique, and the efficiency of intraspinal operation is better than that of IUE technique. Although UBE technique is inferior to IUE technique in terms of surgical trauma, there is no significant difference in postoperative recovery between the two techniques. 目的: 比较后路经椎板间入路单侧双通道脊柱内镜（unilateral biportal endoscopy，UBE）技术与经椎板间窗单通道内镜（interlaminar uniportal endoscopy，IUE）技术治疗L ₅、S ₁椎间盘突出症的临床疗效。. 方法: 回顾分析2020年1月—12月收治且符合选择标准的69例L ₅、S ₁椎间盘突出症患者临床资料。根据采用的内镜手术技术分为UBE组（30例）与IUE组（39例）。两组患者性别构成、年龄、身体质量指数、病程及术前腰腿痛疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）等一般资料比较，差异均无统计学意义（ P>0.05）。记录并比较两组围术期指标［估计失血量（estimated blood loss，EBL）、总手术时间、椎管外操作时间、椎管内减压操作时间、术中放射暴露剂量、切口长度、手术相关并发症及术后住院时间］和临床疗效指标（术前、术后3 d及3、6、12个月腰腿痛VAS评分，以及术前和术后3、6、12个月ODI）。. 结果: 两组患者均顺利完成手术。UBE组切口长度、EBL及椎管外操作时间明显大于IUE组，椎管内减压操作时间明显短于IUE组，差异均有统计学意义（ P<0.05）；两组总手术时间、术中放射暴露剂量及术后住院时间差异均无统计学意义（ P>0.05）。两组患者均获随访，随访时间12～15个月，平均13.3个月。UBE组术中发生硬膜撕裂1例，IUE组术后7个月复发1例，其余患者均未出现手术相关并发症，术后恢复良好。两组术后各时间点腰腿痛VAS评分及ODI均较术前明显改善（ P<0.05）；术后各时间点两组间腰腿痛VAS评分及ODI比较差异均无统计学意义（ P>0.05）。. 结论: UBE技术治疗L ₅、S ₁椎间盘突出症临床疗效与IUE技术相似，椎管内操作效率优于IUE技术；尽管UBE技术在手术创伤方面劣于IUE技术，但患者术后恢复情况无明显差异。.

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