Our Summary

The research paper is about a comparison between two kinds of surgeries for treating lumbar disc herniation (LDH), a condition where the soft center of a spinal disc pushes through the tough exterior, causing pain and discomfort. The two surgeries compared are Unilateral Biportal Endoscopic Discectomy (UBED), a new, minimally invasive method, and the more conventional Percutaneous Endoscopic Lumbar Discectomy (PELD).

The researchers analyzed 12 studies involving 1175 patients with LDH to draw their conclusions. They found that although UBED takes longer to perform and requires a slightly longer hospital stay, it is as effective as PELD in reducing pain and improving a patient’s ability to function.

Interestingly, the newer surgery (UBED) was also linked to a lower chance of LDH coming back compared to the conventional PELD method. However, both surgeries had a similar risk of complications occurring during or immediately after the procedure.

In simple terms, the study suggests that while the newer UBED surgery might take a bit more time and a longer hospital stay, it does the job just as well as the traditional surgery and might even be better at preventing the condition from recurring.

FAQs

  1. What is the main difference between Unilateral Biportal Endoscopic Discectomy (UBED) and Percutaneous Endoscopic Lumbar Discectomy (PELD)?
  2. What advantages does UBED surgery have over PELD according to the study?
  3. Did the study find any difference in the risk of complications between UBED and PELD surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy, based on this research, is to consider the benefits of Unilateral Biportal Endoscopic Discectomy (UBED) for treating lumbar disc herniation. While it may require a slightly longer hospital stay and procedure time compared to Percutaneous Endoscopic Lumbar Discectomy (PELD), UBED has shown to be just as effective in reducing pain and improving function, with a lower risk of the condition coming back. Patients may want to discuss the option of UBED with their doctor to see if it is the best choice for their individual situation.

Suitable For

Patients who are recommended for discectomy typically have symptoms of lumbar disc herniation, such as lower back pain, leg pain, numbness, or weakness. These symptoms are often caused by the compression of nerves in the spine due to the herniated disc.

Patients who have not responded to conservative treatments such as physical therapy, medications, or injections may be recommended for discectomy. Additionally, patients who have severe pain or neurological symptoms that significantly affect their quality of life and daily functioning may also be candidates for surgery.

In the case of the comparison between UBED and PELD surgeries, patients with LDH who are considering surgical treatment may be candidates for either procedure. The decision between the two surgeries may depend on factors such as the patient’s individual preferences, the surgeon’s expertise, and the specific characteristics of the herniated disc.

Timeline

Before the discectomy:

  • Patient experiences symptoms of lumbar disc herniation, such as lower back pain, leg pain, and numbness.
  • Patient undergoes diagnostic tests such as MRI or CT scans to confirm the diagnosis.
  • Patient consults with a spine surgeon to discuss treatment options, including surgery.
  • Patient decides to undergo either UBED or PELD surgery based on the recommendation of the surgeon.

After the discectomy:

  • Patient undergoes surgery, either UBED or PELD, to remove the herniated portion of the disc.
  • Patient may experience some pain and discomfort immediately after the surgery.
  • Patient is monitored in the hospital for a certain period of time, which may be slightly longer for UBED compared to PELD.
  • Patient is discharged from the hospital and begins the recovery process, which may involve physical therapy and pain management.
  • Patient experiences a reduction in pain and improvement in function over time.
  • Patient follows up with the surgeon to monitor progress and address any complications that may arise.

Overall, the timeline for a patient undergoing a discectomy involves pre-surgery consultations and tests, the surgical procedure itself, a period of recovery, and follow-up appointments to ensure successful outcomes.

What to Ask Your Doctor

  1. What is the success rate of Unilateral Biportal Endoscopic Discectomy (UBED) compared to Percutaneous Endoscopic Lumbar Discectomy (PELD) in treating lumbar disc herniation (LDH)?
  2. How long does the recovery process typically take for each surgery?
  3. What are the potential risks and complications associated with both UBED and PELD?
  4. Will I need physical therapy after surgery, and if so, for how long?
  5. Are there any long-term effects or considerations I should be aware of after undergoing either surgery?
  6. How soon after surgery can I expect to see improvements in my pain and function?
  7. What is the likelihood of LDH recurring after UBED versus PELD?
  8. Are there any specific factors or characteristics that make a patient more suitable for one surgery over the other?
  9. What are the differences in cost between UBED and PELD, and will insurance typically cover either procedure?
  10. Are there any alternative treatment options for LDH that I should consider before deciding on surgery?

Reference

Authors: He D, Cheng X, Zheng S, Deng J, Cao J, Wu T, Xu Y. Journal: World Neurosurg. 2023 May;173:e509-e520. doi: 10.1016/j.wneu.2023.02.087. Epub 2023 Feb 24. PMID: 36841538