Abstract
Objective To investigate the recent clinical efficacy of UBED (unilateral two-channel endoscopic disc extraction) and MIS-TLIF (minimally invasive transforaminal approach lumbar interbody fusion) treatment for the treatment of single-segment lumbar disc herniation (LDH). Methods Seventy-three patients with single-segment LDH admitted to the First People's Hospital of Hefei City from December 2019 to January 2022 were selected for the study, and were divided into UBED and MIS-TLIF (Observation Group and Control Group), with 43 and 30 patients in each group, and patients in both groups had the degree of pain (measured by VAS scores) and dysfunction (measured by ODI scores) before and after the operation, functional status of the lumbar spine (measured by JOA score). In addition, some key indicators of the surgical procedure, such as the number of fluoroscopies, operative time, and bleeding, as well as the postoperative recovery, including CRP on the first postoperative day, time to get out of bed, hospitalization time and cost, intervertebral space height of the responsible segments at 3 months postoperatively, vertebral body slippage distances above and below the responsible segments, and the incidence of postoperative complications were also recorded.
Results At one month and three months after operation, the VAS score and ODI score of patients in both groups were lower than those before operation, and the difference was statistically significant (P<0.05). The difference in the incidence of postoperative complications was not statistically significant in the observation group compared with the control group (P>0.05). The VAS and ODI scores, number of intraoperative fluoroscopies, operation time, intraoperative bleeding, CRP on the first postoperative day, time to get out of bed, hospitalization time, hospitalization cost, and vertebral body slip distance above and below the responsible segment in the three months after surgery of the patients in the observation group were lower than those of the control group, and the differences were statistically significant (P<0.05).
Conclusion Both UBED and MIS-TLIF can reduce patients' low back and leg pain and dysfunction, and compared with MIS-TLIF, UBED has significant advantages in improving the treatment effect, shortening the operation time, reducing the number of fluoroscopies, the amount of intraoperative bleeding, and reducing the economic burden, but MIS-TLIF is conducive to the improvement of the lumbar spine stability and lumbar spine function.