Our Summary

This study compared two minimally invasive surgical methods for treating patients with a specific type of lower back (lumbar) disc herniation. The two procedures are called Unilateral Biportal Endoscopic Discectomy (UBE) and Percutaneous Endoscopic Lumbar Discectomy (PELD).

The study looked at 54 patients who had one of these procedures (24 had UBE and 30 had PELD) and followed them for at least 6 months. They measured things like how long the surgery took, how long the incision was, how long the patients stayed in the hospital, how much blood was lost during and after surgery, any complications that occurred, the total cost of the hospital stay, and measures of pain and disability before and after surgery.

The results showed that both procedures significantly reduced pain and disability. However, the UBE procedure generally had more drawbacks than the PELD procedure. Patients who had UBE had more total blood loss, more blood loss during surgery, more hidden blood loss (which is blood loss that isn’t immediately apparent), longer surgeries, longer hospital stays, longer incisions, and higher total hospital costs. However, there was no significant difference in the rate of complications between the two groups.

In conclusion, while UBE did help patients with their pain and disability, it had more drawbacks compared to PELD.

FAQs

  1. What were the two minimally invasive surgical methods compared in the study for treating lumbar disc herniation?
  2. What were the drawbacks observed in the UBE procedure compared to the PELD procedure according to the study?
  3. Was there a difference in the rate of complications between the UBE and PELD procedures?

Doctor’s Tip

Therefore, a helpful tip a doctor might give a patient considering a discectomy would be to discuss the potential benefits and drawbacks of different minimally invasive surgical methods with their healthcare provider to determine the best option for their individual situation. It’s important to weigh the potential risks and benefits to make an informed decision about the procedure.

Suitable For

Patients who are typically recommended for discectomy are those who have a specific type of lower back disc herniation that is causing significant pain and disability that has not improved with conservative treatments such as physical therapy or medication. These patients may have radiating leg pain, weakness, numbness, or tingling due to nerve compression from the herniated disc. Discectomy is often recommended when the symptoms are severe and impacting the patient’s quality of life.

Timeline

Before the discectomy procedure, a patient typically experiences symptoms such as lower back pain, leg pain, numbness, and weakness. They may have tried conservative treatments such as physical therapy, medications, and injections with limited success. After consulting with a spine specialist and undergoing imaging tests to confirm a lumbar disc herniation, the patient decides to undergo a discectomy to alleviate their symptoms.

During the discectomy procedure, the surgeon makes a small incision in the lower back and uses special tools to remove the herniated portion of the disc that is pressing on the nerves. The surgery generally takes around 1-2 hours to complete, and the patient may need to stay in the hospital for a day or two for monitoring.

After the discectomy, the patient typically experiences immediate relief from leg pain and numbness. However, they may still have some residual lower back pain and stiffness, which gradually improves over the following weeks and months. The patient is advised to gradually resume normal activities and may undergo physical therapy to strengthen the muscles supporting the spine.

In the months following the discectomy, the patient continues to see improvement in their symptoms, with reduced pain and increased mobility. They are able to return to their normal daily activities and may even resume more strenuous activities such as exercise and sports. Overall, the discectomy procedure helps the patient regain their quality of life and function with minimal disruption.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy may include:

  1. What are the potential risks and complications associated with both Unilateral Biportal Endoscopic Discectomy (UBE) and Percutaneous Endoscopic Lumbar Discectomy (PELD)?
  2. How long is the recovery process for each procedure, and what can I expect in terms of pain and limitations during this time?
  3. Are there any specific factors that make me a better candidate for one procedure over the other?
  4. How long will the effects of the surgery last, and what is the likelihood of needing additional treatment in the future?
  5. Can I see before and after images of patients who have had each procedure to understand the potential outcomes?
  6. What is the success rate of each procedure in terms of relieving pain and improving function in patients with my specific type of disc herniation?
  7. Are there any alternative treatments or therapies that I should consider before deciding on surgery?
  8. What is the experience and expertise of the surgical team in performing both UBE and PELD procedures?
  9. How will the cost of each procedure be covered by my insurance, and what out-of-pocket expenses should I expect?
  10. What is the long-term prognosis for patients who undergo either UBE or PELD in terms of preventing future disc herniation or complications?

Reference

Authors: Jiang HW, Chen CD, Zhan BS, Wang YL, Tang P, Jiang XS. Journal: J Orthop Surg Res. 2022 Jan 15;17(1):30. doi: 10.1186/s13018-022-02929-5. PMID: 35033143