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Comparison of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) for symptomatic lumbar disc herniation

European Spine Journal volume 32, pages 542–554 (2023)Cite this article

Abstract

Purpose

This study aimed to evaluate the clinical outcomes of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) in the treatment of symptomatic lumbar disc herniation (LDH).

Methods

From January 2020 and May 2021, 128 patients with single-level LDH at L4-5 or L5-S1 received FEFLD, UBE discectomy or MD. Patients were divided into three groups according to surgical method: the FEFLD group (n = 43), the UBE group (n = 42), and the MD group (n = 43). Operative time, fluoroscopy frequency, in-bed time, length of hospital stays, total expenses, complications, visual analogue scale (VAS, 0–10), and Oswestry Disability Index (ODI, 0–100%) were assessed and compared among three groups.

Results

There were no significant differences in VAS or ODI scores at 12 months after surgery among three groups. In comparison with the MD group, the FEFLD and UBE group yield better VAS scores for back pain on the first day following surgery (P < 0.05). The FEFLD group was superior to the UBE group or MD group with less time in bed and shorter hospital stay (P < 0.05). The operation time and total expenses in the UBE group were significantly longer and higher than those in the FEFLD group or MD group (P < 0.05).

Conclusions

FEFLD and UBE discectomy yield comparable results to conventional MD concerning pain relief and functional outcomes. In addition, FEFLD and UBE discectomy enable less back pain in the immediate postoperative period. FEFLD offers advantages in rapid recovery. Conventional MD is still an efficient and cost-effective surgical procedure.

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Data and materials availability

Raw data would be made available on reasonable request and with the permission of the institution where the data were generated. Hengrui Chang was the person to be contacted if someone wants to request the data from this study.

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Acknowledgements

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Author notes

  1. Hengrui Chang and Jiaxin Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Hengrui Chang, Jiaxin Xu & Wenyuan Ding

  2. Hebei Medical University, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Hengrui Chang, Dalong Yang, Jiayuan Sun & Xianda Gao

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Contributions

WYD designed the study; HRC and JXX searched relevant studies; HRC, JXX and DLY analysed and interpreted the data; HRC wrote the manuscript; and WYD approved the final version of the manuscript.

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Correspondence to Wenyuan Ding.

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Chang, H., Xu, J., Yang, D. et al. Comparison of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) for symptomatic lumbar disc herniation. Eur Spine J 32, 542–554 (2023). https://doi.org/10.1007/s00586-022-07510-6

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  • DOI: https://doi.org/10.1007/s00586-022-07510-6

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