Abstract:

Objective To compare the clinical efficacy and imaging results of uniportal interlaminar endoscopy （UIE） and unilateral biportal endoscopy （UBE） for the treatment of lumbar disc herniation. Methods The clinical information for 50 patients diagnosed with lumbar disc herniation was collected，and treated by UIE endoscopic surgery and UBE endoscopic surgery in the The First People's Hospital of Hefei city from March 2021 to October 2022 were retrospectively analyzed. The patients were divided into two groups， UIE group and the UBE group. Perioperative indexes including incision length， operation time， intraoperative blood loss， and surgical complications， clinical efficacy indexes including VAS scores of low back pain and leg pain before surgery， 3 days after surgery， 3 months after surgery， 6 months after surgery， and 12 months after surgery， ODI scores of dysfunction index， and imaging results including spinal canal area， vertebral space height， before surgery and 1 year after surgery were recorded and compared between the two groups. Results Both groups completed the procedure and were followed up for 12 ~ 18 months， with an average of 15 months. 1 case was dural injury， no nerve root injury， and no nerve root symptoms during the follow-up. The symptoms of lumbar and leg pain were all relieved in both groups after the procedure. The UBE groups hawed larger surgical incisions， more intraoperative blood loss， and shorter operative time compared to the UIE group （P < 0.05， respectively）. Both groups had significant developments in the VAS scores， ODI scores of back， and leg pain at 3 days， 3 months， 6 months， and 12 months after the operation（all P < 0.05）. The UIE group showed significant developments in the VAS scores and ODI scores of back and leg pain at 3 days and 3 months after the operation， as compared to the UBE group （P < 0.05）. The imaging analysis did not showed significant changes in the height of intervertebral space and the angle of lumbar lordosis， but a significantly larger increase in the dural sac area in both groups one year after the procedure， and the UBE group had even a larger increase than the UIE group （P < 0.05）. Conclusion Both UIE and UBE have good clinical efficacy and imaging results in the treatment of lumbar disc herniation via interlaminal approach. However， the UIE group is superior to the UBE group in terms of the operation time， intraoperative blood loss， postoperative VAS score of low back pain as well as the decompression effectiveness.

Key words: lumbar disc herniation, unilateral biportal endoscopy, uniportal interlaminarendoscopy