Clinical comparison of unilateral biportal endoscopic discectomy with percutaneous endoscopic lumbar discectomy for single l4/5‐level lumbar disk herniation

Hao, Jie; Cheng, Jiaqi; Xue, Huawei; Zhang, Feng

doi:10.1111/papr.13078

Cited by 28 publications

(42 citation statements)

References 31 publications

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“…ODI scores reflect functional recovery of patients after surgery. Both UBE and PELD were effective in promoting functional recovery in patients, but there was no significant difference between them, which is consistent with the findings of the study by Hao et al [ 17 ]. Our study found no difference between UBE and PELD in terms of complications, and UBE has the same safety profile as PELD.…”

Section: Discussionsupporting

confidence: 91%

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Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Zhu

Yao

Huang

et al. 2022

Applied Bionics and Biomechanics

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Objective. Spinal surgery is gradually moving toward minimally invasive surgery, but there is still some lack of knowledge about the Unilateral Biportal Endoscopic (UBE) technique that has been hotly debated in recent years. We performed this systematic review and meta-analysis to clarify whether UBE is superior to percutaneous endoscopic lumbar discectomy (PELD) for relieving short-term postoperative pain and promoting functional recovery. Methods. Computer searches of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were performed to search for studies on UBE versus PELD for single-segment lumbar disc herniation (ssLDH) from the time of database construction to Mar. 2022, and two investigators independently performed literature screening and data extraction, and evaluation of the quality of the included studies was observed as operation time, complications, and visual analogue scale (VAS) at each preoperative and postoperative stage as well as Oswestry Disability Index (ODI), and meta-analysis was performed by applying the Review Manager 5.4 software. Results. Meta-analysis showed that PELD had shorter operation time ( MD = 35.36 , 95% CI (4.67, 66.04), P = 0.02 ) and had lower VAS of back pain at 3 days postoperatively ( MD = 0.62 , 95% CI (0.04, 1.19), P = 0.04 ) compared to the UBE. However, there was no statistical significance between the two groups in terms of complications ( MD = 2.53 , 95% CI (0.40, 16.11), P = 0.33 ), VAS of back pain at 30 days postoperatively ( MD = 0.05 , 95% CI (-0.19, 0.28), P = 0.70 ), VAS of leg pain at 3 days postoperatively ( MD = 0.21 , 95% CI (-0.20, 0.61), P = 0.33 ), VAS of leg pain at 30 days postoperatively ( MD = 0.09 , 95% CI (-0.29, 0.46), P = 0.65 ), and ODI at 30 days postoperatively ( MD = − 0.81 , 95% CI (-3.03, 1.41), P = 0.47 ). Conclusions. Current evidence suggests that both UBE and PELD are effective in relieving short-term postoperative pain and promoting functional recovery, and there is no difference in complications between them; UBE requires longer operation time, and PELD may be superior in relieving immediate postoperative pain. This trial is registered with PROSPERO ID: CRD42021287810.

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Section: Discussionsupporting

confidence: 91%

“…Two studies [ 17 , 18 ] reported complications between UBE and PELD (94 patients, 44 in the UBE group and 50 in the PELD group). Meta-analysis showed no statistically significant difference in complications between the two groups (WMD = 2.53, 95% CI (0.40, 16.11), P = 0.33, heterogeneity: χ 2 = 0.10, df = 1 ( P = 0.76), I 2 = 0%).…”

Section: Resultsmentioning

confidence: 99%

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Zhu

Yao

Huang

et al. 2022

Applied Bionics and Biomechanics

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“…The study selection flow chart is shown in Figure 1. The 16 eligible articles (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) included 19 comparison groups, with a combined 653 patients who underwent UBE, 612 who underwent MED, 153 who underwent PELD, and 70 who underwent PLIF. Of the 16 included articles, 2 were RCTs, 5 were cohort studies, and 9 were case-control studies.…”

Section: Study Selectionmentioning

confidence: 99%

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Zheng

Xu²,

Chen³

et al. 2022

Front. Surg.

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BackgroundThis study aimed to evaluate the efficacy and safety of unilateral biportal endoscopy (UBE) versus other forms of spine surgery.MethodsElectronic databases were systematically searched up to February 2022. The authors used Review Manager 5.3 to manage the data and perform the review.ResultsAfter the preliminary selection of 239 studies from electronic databases, the full inclusion criteria were applied; 16 studies were found to be eligible for inclusion. These 16 studies enrolled 1,488 patients: 653 patients in the UBE group, 570 in the microendoscopic discectomy group, 153 in the percutaneous endoscopic lumbar discectomy group, and 70 in the posterior lumbar interbody fusion group. UBE was superior to microendoscopic discectomy regarding 1-day Visual Analog Scale(VAS) back pain scores (P < 0.00001). No difference was found between UBE and microendoscopic discectomy regarding 1-day Visual Analog Scale leg pain scores (P = 0.25), long-term VAS back pain scores (P = 0.06), long-term VAS leg pain scores (P = 0.05), Oswestry Disability Index scores (P = 0.09) or complications (P = 0.19). Pooled analysis indicated that UBE was similar to percutaneous endoscopic lumbar discectomy regarding 1-day VAS back pain scores (P = 0.71), 1-day VAS leg pain scores (P = 0.37), long-term VAS back pain scores (P = 0.75), long-term VAS leg pain scores (P = 0.41), Oswestry Disability Index scores (P = 0.07) and complications (P = 0.88). One study reported no difference between UBE and posterior lumbar interbody fusion regarding long-term VAS back pain, long-term VAS leg pain, or Oswestry Disability Index scores.ConclusionsUBE is superior to microendoscopic discectomy to relieve back pain 1 day postoperatively. However, these two procedures are similar regarding 1-day leg pain relief, long-term effects, and safety. UBE and percutaneous endoscopic lumbar discectomy are similar regarding 1-day pain relief, long-term effects and safety. More evidence is needed to evaluate the efficacy and safety of UBE versus posterior lumbar interbody fusion.

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“…It is mainly divided into the TF and the IL different surgical approaches and is widely used in clinical practice. Even when compared with other types of minimally invasive surgery, such as MIS-TLIF and unilateral biportal endoscopic discectomy, PELD performed obviously less intraoperative blood loss, shorter operative time, lighter low back, and leg pain postoperative ( 7 , 8 ). Although it has minimally invasive features, PELD requires the destruction of back soft tissue and lumbar disc structure, which inevitably leads to postoperative pain and recurrence in patients, and recurrence rates of LDH have been reported in the literature ranging from 5 to 15 percent ( 9 ).…”

Section: Discussionmentioning

confidence: 94%

Whether Out-of-Bed Activity Restriction in the Early Postoperative Period of PELD Is Beneficial to Therapeutic Efficacy or Reduce Recurrence

Xiao

Yue²,

et al. 2022

Front. Surg.

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ObjectiveTo detect the influences of postoperative out-of-bed activity restriction on recurrence rate, low back and leg pain, functional rehabilitation after percutaneous endoscopic lumbar discectomy (PELD).MethodsIn this research, 213 patients with lumbar intervertebral disc herniation (LDH) who underwent PELD were divided into the out-of-bed activity restriction group and out-of-bed activity non-restriction group. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate postoperative clinical efficacy at 1 and 3 months after the operation, and to count the recurrence rates. All of these operations were performed between August 2017 and July 2020, and they were followed in the outpatient department for 12 months at least.ResultsBoth of the groups showed significantly lower VAS and higher ODI scores at 1 month and 3 months post-operation, respectively, when compared with pre-operation. At 1 month after the operation, the restriction group performed lower VAS scores of low back pain compared with the non-restriction group, but this advantage disappeared at 3months post-operation. However, there was no statistical difference in the VAS scores of leg pain and ODI scores between the two groups, neither at 1 nor 3 months after the surgery. The recurrence rate is significantly lower in the restriction group than in the non-restriction group at a 12-month follow-up after the surgery.ConclusionOut-of-bed activity restriction in the early postoperative period of PELD could reduce LDH recurrence effectively, and it may relieve the low back pain to some extent. It has no benefit in the recovery of leg pain and functional rehabilitation.

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Clinical comparison of unilateral biportal endoscopic discectomy with percutaneous endoscopic lumbar discectomy for single l4/5‐level lumbar disk herniation

Cited by 28 publications

References 31 publications

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Efficacy and safety of unilateral biportal endoscopy versus other spine surgery: A systematic review and meta-analysis

Whether Out-of-Bed Activity Restriction in the Early Postoperative Period of PELD Is Beneficial to Therapeutic Efficacy or Reduce Recurrence

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