Biportal Endoscopic Discectomy for Lumbar Disc Hernia

A single-level herniated lumbar disc refers to a specific condition in the spine where one of the intervertebral discs in the lumbar (lower back) region of the spine has moved out of its normal position and is pressing on nearby nerves. When a lumbar disc herniates, it can exert pressure on the adjacent spinal nerves, causing a range of symptoms, including lower back pain, leg pain (sciatica), numbness, tingling, and muscle weakness. The specific symptoms and their severity can vary depending on the location and extent of the herniation. Biportal endoscopic discectomy has become a popular treatment option for single-level herniated lumbar discs. While it has shown promise in clinical outcomes, there remains a need for more evidence regarding its effectiveness and safety.

Clinical Trial

A clinical trial compared the efficacy and safety of biportal endoscopic discectomy with an open microscopic discectomy in patients with low back and leg pain due to single-level herniated lumbar discs. Sixty-four participants in need of discectomy were included in this study. They were randomly assigned to either the biportal endoscopic or microscopic discectomy groups.

Various patient-reported outcome measures (PROMs) were used to assess outcomes, including pain scores measured by the visual analog scale (VAS) for the surgical site, lower back, and lower extremities. The Oswestry Disability Index (ODI) measured lumbar disabilities, while the European Quality of Life-5 Dimensions evaluated the quality of life. The presence of neuropathic pain was assessed using the painDETECT scale. Surgical-related outcomes such as hospital stay, operation time, and opioid usage were also recorded. Adverse events throughout the follow-up period were noted.

Results

At the 12-month follow-up, the ODI score in the biportal group was 13.89, compared to 11.97 in the microscopic group. Secondary outcomes aligned with these findings; creatinine phosphokinase ratios were lower in the biportal group. Early surgical site pain was slightly reduced in the biportal group at the 48-hour mark.

Conclusion

This study concludes that biportal endoscopic discectomy is non-inferior to open microscopic discectomy over 12 months. It represents a relatively safe and effective surgical technique with reduced muscle damage. However, the study also suggests that clinicians should carefully consider the implications of surgical site pain. This research contributes valuable insights into the treatment options for patients with single-level herniated lumbar discs and helps medical professionals choose appropriate surgical approaches.
__________

Share this article with a friend: