Yin Jianjian, Gao Gongming, Chen Senlin, Ma Tao, Nong Luming
Department of Orthopedics, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
Department of Orthopedics, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
World Neurosurg. 2025 Feb;194:123526. doi: 10.1016/j.wneu.2024.11.109. Epub 2024 Dec 18.
To compare the clinical outcomes of unilateral biportal endoscopic discectomy (UBED) and percutaneous interlaminar endoscopic discectomy (PIED) for treating L5/S1 disc herniation.
Patients with L5/S1 disc herniation treated with UBED (n = 46) and PIED (n = 50) in our hospital during the same period were retrospectively reviewed. Clinical outcome, radiographic parameters, and complications of each group were collected and evaluated.
The mean follow-up period was 14.11 ± 3.47 months in the UBED group and 14.52 ± 5.37 months in the PIED group. There was no significant difference in visual analog scale score for the leg (P = 0.836) or lumbar scores (P = 0.335) between PIED and UBED group at preoperative, 1-day postoperative, and last follow-up point. Within the same group, there were significant differences in visual analog scale score for the leg (P < 0.001) and lumbar scores (P < 0.001) compared pairwise at 3 time points. Oswestry Disability Index scores of both groups showed significant improvement at the last follow-up (P < 0.001, P < 0.001), and there was no significant difference in patient satisfaction rates (97.8% vs. 96%) between the 2 groups on the basis of the MacNab criteria. The percentage of facet joint preservation was 96.74 ± 9.10% in the UBED group and 99.22 ± 1.52% in the PIED group. The total blood loss and hospitalization cost was greater in the UBED group. One patient in both groups showed postoperative hematoma. A dural tear occurred in UBED group and a never root injury occurred in the PIED group.
UBED indicates similar short-term efficacy compared with PIED for treating L5/S1 disc herniation. No difference was found in facet joint preservation between the 2 groups. We believe the increased cost of UBED as the result of surgical consumables will decrease in the future.
比较单侧双孔道内镜下椎间盘切除术（UBED）和经皮椎间孔内镜下椎间盘切除术（PIED）治疗L5/S1椎间盘突出症的临床疗效。
回顾性分析我院同期接受UBED治疗的L5/S1椎间盘突出症患者46例（UBED组）和接受PIED治疗的患者50例（PIED组）。收集并评估每组患者的临床疗效、影像学参数及并发症。
UBED组平均随访时间为14.11±3.47个月，PIED组为14.52±5.37个月。术前、术后1天及末次随访时，PIED组与UBED组腿痛视觉模拟评分（P = 0.836）及腰椎评分（P = 0.335）差异均无统计学意义。同组内，3个时间点两两比较，腿痛视觉模拟评分（P < 0.001）及腰椎评分（P < 0.001）差异均有统计学意义。两组患者末次随访时Oswestry功能障碍指数评分均显著改善（P < 0.001，P < 0.001），基于MacNab标准，两组患者满意度差异无统计学意义（97.8% vs. 96%）。UBED组小关节保留率为96.74±9.10%，PIED组为99.22±1.52%。UBED组总失血量及住院费用更高。两组各有1例患者出现术后血肿。UBED组发生1例硬膜撕裂，PIED组发生1例神经损伤。
对于L5/S1椎间盘突出症，UBED与PIED的短期疗效相似。两组小关节保留率无差异。我们认为，未来手术耗材导致的UBED费用增加将会降低。
