Comparative Analysis Of The Efficacy Of Unilateral Biportal Endoscopy And Percutaneous Endoscopic Lumbar Discectomy In The Treatment Of Lumbar Disc Herniation

Objective:A retrospective study compared the efficacy of unilateral biportal endoscopy and percutaneous endoscopic lumbar discectomy in reducing clinical symptoms after lumbar disc nucleus pulposus removal in patients with lumbar disc herniation.Methods:A retrospective analysis was performed on the medical records of patients hospitalized in the Department of Orthopedics of Baoding First Central Hospital from January 2021 to August 2022,and 80 patients with lumbar disc herniation(L5/S1),48 male patients and 32 female patients met the exclusion criteria.According to the different surgical treatment methods of patients,they were divided into two groups,one group was percutaneous endoscopic interlaminar discectomy(n=40)and the other group was unilateral biportal endoscopy(n=40),and all surgical operators were performed by senior doctors with more than 15 years of experience in spine surgery.The observation indicators included: length of hospitalization,operation time,hemoglobin before and after surgery,erythrocyte sedimentation rate before and after surgery,C-reactive protein before and after surgery;Visual analogue scores(waist and legs)at 1 day,1 week,1month and 3 months before and after surgery,and improved dysfunction index scores at 1 week,January and March before and after surgery;Modification of Macnab score at last follow-up,postoperative complications.The resulting data is put into statistical software for statistical analysis.Results:One patient in the percutaneous endoscopic interlaminar discectomy group relapsed the day after surgery,and 79 patients were included.The postoperative clinical symptoms of the two different surgical methods were significantly improved,and the low back pain score,leg pain score and dysfunction index score were compared with the preoperative score(p<0.05).The bleeding of the two surgical methods had a certain effect on the amount of hemoglobin(P<0.05),there was no statistically significant difference in the postoperative hemoglobin value between the two groups(P>0.05),and the percutaneous endoscopic interlaminar discectomy group had less hemoglobin loss(P<0.05).The time required for surgery,the difference in C-reactive protein before and after surgery,the value of C-reactive protein on the first day after surgery,and the total treatment time of patients in the percutaneous endoscopic interlaminar discectomy group were less(P<0.05).The lower back pain score(P<0.05)was higher in the unilateral biportal endoscopic group,and there were no statistically significant differences in the low back pain score,leg pain score,and dysfunction index score between the two groups in the remaining time periods(P>0.05).Complications: There were 2 cases of surgical complications in the unilateral biportal endoscopy group.There were 2 cases of surgical complications in the percutaneous endoscopic interlaminar discectomy group.There was no statistically significant difference in the incidence of surgical complications between the two groups(p>0.05).The last follow-up after surgery showed an excellent rate of 100% between the two groups,30:10 in the unilateral biportal endoscopy group and 26:13 in the percutaneous endoscopic interlaminar discectomy group,and there was no statistically significant difference in the excellent rate between the two groups(p>0.05).Conclusions:Unilateral biportal endoscopy and percutaneous endoscopic lumbar discectomy have similar clinical effects in the treatment of simple lumbar disc herniation,both of which reduce patient suffering.Percutaneous endoscopic lumbar discectomy offers advantages in terms of length of hospital stay,length of surgery,surgical trauma,and haemoglobin loss.