Clinical comparison of percutaneous transforaminal endoscopic discectomy and unilateral biportal endoscopic discectomy for single-level lumbar disc herniation

Xiaokang Cheng; Beixi Bao; Yuxuan Wu; Yuanpei Cheng; Chunyang Xu; Yang Ye; Chentao Dou; Bin Chen; Hui Yan; Jiaguang Tang

doi:10.3389/fsurg.2022.1107883

Clinical comparison of percutaneous transforaminal endoscopic discectomy and unilateral biportal endoscopic discectomy for single-level lumbar disc herniation

Front Surg. 2023 Jan 16:9:1107883. doi: 10.3389/fsurg.2022.1107883. eCollection 2022.

Authors

Xiaokang Cheng^{1

2}, Beixi Bao¹, Yuxuan Wu¹, Yuanpei Cheng³, Chunyang Xu¹, Yang Ye¹, Chentao Dou², Bin Chen², Hui Yan¹, Jiaguang Tang¹

Affiliations

¹ Department of Orthopedics, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
² Department of Orthopedics, Chengde Medical University Affiliated Hospital, Chengde, China.
³ Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China.

Abstract

Purpose: To compare the clinical outcomes of percutaneous transforaminal endoscopic discectomy (PTED) and unilateral biportal endoscopic discectomy (UBE) for the treatment of single-level lumbar disc herniation (LDH).

Materials and methods: From January 2020 to November 2021, 62 patients with single-level LDH were retrospectively reviewed. All patients underwent spinal surgeries at the Affiliated Hospital of Chengde Medical University and Beijing Tongren Hospital, Capital Medical University. Among them, 30 patients were treated with UBE, and 32 were treated with PTED. The patients were followed up for at least one year. Patient demographics and perioperative outcomes were reviewed before and after surgery. The Oswestry Disability Index (ODI), visual analog scale (VAS) for back pain and leg pain, and modified MacNab criteria were used to evaluate the clinical outcomes. x-ray examinations were performed one year after surgery to assess the stability of the lumbar spine.

Results: The mean ages in the UBE and PTED groups were 46.7 years and 48.0 years, respectively. Compared to the UBE group, the PTED group had better VAS scores for back pain at 1 and 7 days after surgery (3.06 ± 0.80 vs. 4.03 ± 0.81, P < 0.05; 2.81 ± 0.60 vs. 3.70 ± 0.79, P < 0.05). The UBE and PTED groups demonstrated significant improvements in the VAS score for leg pain and ODI score, and no significant differences were found between the groups at any time after the first month (P > 0.05). Although the good-to-excellent rate of the modified MacNab criteria in the UBE group was similar to that in the PTED group (86.7% vs. 87.5%, P > 0.05), PTED was advantageous in terms of the operation time, estimated blood loss, incision length, and length of postoperative hospital stay.

Conclusions: Both UBE and PTED have favorable outcomes in patients with single-level LDH. However, PTED is superior to UBE in terms of short-term postoperative back pain relief and perioperative quality of life.

Keywords: endoscopic; lumbar disc herniation; minimally invasive surgery; percutaneous transforaminal endoscopic discectomy; unilateral biportal endoscopic discectomy.