Objectives To compare the short-term clinical efficacy of unilateral biportal endoscopic discectomy(UBED) and percutaneous endoscopic interlaminar discectomy(PEID) in the treatment of L5/S1 lumbar disc herniation(LDH). Methods From January 2020 to August 2022, 39 patients with L5/S1 LDH were treated with UBED or PEID in our hospital, including 24 cases in UBED group and 15 cases in PEID group. The operation time, incision length, intraoperative fluoroscopy times, intraoperative blood loss, volume of lavage fluid, changes in creatine kinase (CK) before and after surgery, postoperative hospital stay and complications were recorded and compared between the two groups. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate and compare the quality of life of patients in the two groups before operation, 3 days after operation, 1 month after operation and 6 months after operation. Results In UBED group, 1 patient had dural sac rupture during operation and 1 patient had headache after operation. One patient in PEID group had burning pain in S1 nerve root innervation area in the early postoperative period. The incision length in UBED group was longer than that in PEID group (32.6±3.9 mm vs 9.8±1.3 mm, P<0.05), and the volume of lavage fluid used was more than that in PEID group (11.1±2.3 L vs 6.5±1.1 L, P<0.05). The postoperative CK was higher than that in PEID group (351.8±99.9 U/L vs 241.4± 49.6 U/L, P<0.05), and the operation time was shorter than that in PEID group (91.5±14.8 min vs 130.4±13.8 min, P<0.05). There was no significant difference between the two groups in intraoperative fluoroscopy times, intraoperative blood loss, postoperative hospital stay and complications (P>0.05). VAS score and ODI at 3 days, 1 month and 6 months after operation were significantly lower in both groups than those before operation (P<0.05), and there was no statistical difference between the two groups (P>0.05). Conclusions UBED and PEID are both safe and effective minimally invasive surgical methods for the treatment of L5/S1 LDH, which can effectively reduce the number of intraoperative fluoroscopy and obtain similar pain relief, and improve the quality of life of patients. UBED has wider surgical field and larger operating space, while PEID has less trauma.
Key words
Lumbar disc herniation /
Unilateral biportal endoscopic discectomy /
Percutaneous endoscopic interlaminar discectomy
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