Water Dynamics in Unilateral Biportal Endoscopic Spine Surgery and Its Related Factors: An In Vivo Proportional Regression and Proficiency-Matched Study

Hong, Young-Ho; Kim, Seung-Kook; Hwang, Juyoung; Eum, Jin-hwa; Heo, Dong Hwa; Suh, Dongwon; Lee, Su-Chan

doi:10.1016/j.wneu.2021.01.086

Cited by 34 publications

(20 citation statements)

References 22 publications

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“…Continuous flushing provides a clear surgical view and a higher safety profile. However, on the other hand, high flushing pressure may lead to complications such as postoperative headache and dural sac injury [ 33 ]. Since only two studies were included, this finding should be viewed with caution.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…Moreover, high-pressure irrigation is not advised since it might increase intracranial pressure and cause delayed postoperative recovery (28). To minimize potential iatrogenic injury, water pressure should be managed between 4.41 cm H 2 O (2.41 mmHg) and 31.00 cm H 2 O (22.83 mmHg) during UBE (29). In addition, the risk factors for epidural hematoma after UBE were preoperative anticoagulant usage, female sex, old age, intraoperative water infusion pump application, and surgery requiring greater bone There is also a period of adaptation on the learning curve for UBE ULBD, including extended operative time for decompression owing to a murky surgical field caused by minor bleeds and, recurrent dura rupture caused by a lack of information on the endoscopic vision and surgical anatomy.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of clinical effects of microscopic unilateral laminectomy bilateral decompression (ULBD) versus biportal endoscopic ULBD for lumbar canal stenosis

et al. 2022

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OsbjectiveSeveral studies have shown that both microscopic unilateral laminotomy bilateral decompression (ULBD) and unilateral biportal endoscopic (UBE) ULBD are effective for treating lumbar canal stenosis (LCS). However, there are different viewpoints as to which surgical technique is superior. Therefore, this meta-analysis investigated the clinical efficacy and side effects of microscopic ULBD and UBE ULBD for treating LCS.MethodsTo identify relevant studies describing the clinical outcomes and complication rates of microscopic ULBD and UBE ULBD for LCS, several databases were systematically searched in the Internet. The visual analog scale score for back and leg pain and the Oswestry Disability Index were used to assess clinical outcomes. Furthermore, data about perioperative outcomes and complications were documented.ResultsIn total, six studies with 450 participants were included in this meta-analysis. The UBE ULBD was found to be superior to microscopic ULBD in terms of efficacy against early postoperative back and leg pain. However, there was no significant difference between the two procedures in terms of final clinical outcomes and complications. In addition, compared with microscopic ULBD, UBE ULBD was associated with a significant reduction in the length of hospital stay and C-reactive protein levels 2 days after surgery.ConclusionUBE ULBD and microscopic ULBD for the treatment of LCS were similar in terms of final clinical outcomes and complications. However, UBE ULBD has several advantages over microscopic ULBE, including a shorter hospital stay and faster alleviation of postoperative back and leg pain.

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“…The interference of lumbar paraspinal muscles in UBE has attracted increasing attention from researchers [10][11][12]. Ahn Jae-Sung found that significant postoperative changes in the paraspinal muscles of UBE surgery by comparing the MRI scans [13].…”

Section: Discussionmentioning

confidence: 99%

Unilateral Biportal Endoscopy Discectomy for High Grade Migrated Lumbar Disk Herniation with a Homemade Guider

Liu¹

2022

IJCIMR

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Percutaneous endoscopic discectomy treating high-migration disc herniation is still technical challenging. Unilateral biportal endoscopic discectomy is a potential surgical method for migrated herniation discectomy. Although UBE discectomy is more minimally invasive compared with the open surgery, the dissection of soft tissue during surgical exposure has received increasing research attention. To reduce the damage of paravertebral muscle, we introduced a homemade guider assisting UBE discectomy of high-migrated upper lumbar disc herniation and reported the related clinical outcomes. The use of self-designed guidelines for UBE can quickly and accurately establish the surgical field, simplify the operation process and reduce paravertebral muscle damage.

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Water Dynamics in Unilateral Biportal Endoscopic Spine Surgery and Its Related Factors: An In Vivo Proportional Regression and Proficiency-Matched Study

Cited by 34 publications

References 22 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

A meta-analysis of clinical effects of microscopic unilateral laminectomy bilateral decompression (ULBD) versus biportal endoscopic ULBD for lumbar canal stenosis

Unilateral Biportal Endoscopy Discectomy for High Grade Migrated Lumbar Disk Herniation with a Homemade Guider

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