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Biportal endoscopic discectomy versus tubular microscopic discectomy for treating single-level lumbar disc herniation in obese patients: a multicenter, retrospective analysis

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Abstract

Purpose

In microscopic lumbar discectomy in obese patients, a correlation is found between the operation time and increase in estimated blood loss according to the increase in body mass index; however, no studies have investigated the outcomes of biportal endoscopic lumbar discectomy in obese patients. Therefore, this study aimed to compare the clinical and radiographic outcomes of microscopic and endoscopic discectomy in obese patients with lumbar herniated discs.

Methods

In this multicenter, retrospective study, clinical and radiological data were compared and analyzed in 73 obese patients with a body mass index of > 30 kg/m2 who underwent microscopic or biportal endoscopic lumbar discectomy. Clinical data on the visual analog scale (VAS), Oswestry disability index (ODI), and EuroQol-5D (EQ-5D) scores were measured, and radiological data were obtained using magnetic resonance imaging (MRI).

Results

This study enrolled 43 patients who underwent microscopic discectomy and 30 who underwent biportal endoscopic discectomy. The VAS, ODI, and EQ-5D scores in both groups improved after surgery compared with those before surgery, although there was no difference between the two groups. Although there was a difference in the incidence of recurrent disc herniation confirmed by MRI after surgery, no difference was found in the number of patients requiring surgery between the two groups.

Conclusion

In obese patients with lumbar disc herniation that was not improved with conservative treatment, no significant clinical or radiological differences in outcomes were noted between microscopic and biportal endoscopic surgery methods. In contrast, minor complications were less common in the biportal group.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing.

Author information

Author notes

  1. Jun-Young Choi and Hyun-Jin Park equally contributed to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang-Si, Gyeonggi-Do, Republic of Korea

    Jun-Young Choi

  2. Department of Orthopaedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea

    Hyun-Jin Park, Ki-Han You, Jae-Yeon Hwang & Joon-Hyeok Yoon

  3. Department of Orthopaedic Surgery, Spine Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea

    Sang-Min Park, Ho-Joong Kim & Jin S. Yeom

  4. Department of Orthopaedic Surgery, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea

    Min-Seok Kang

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Contributions

S.M. Park and H.J. Park contributed to the conception of the study. H.J. Park, S.M. Park, K.H. You, and J.Y. Choi wrote the manuscript. H.J. Kim and J.S. Yeom collected and analyzed data. M.S. Kang, J.Y. Hwang, and J.H. Kim reviewed the manuscript. All authors of the manuscript have read and agreed to its content and are accountable for all aspects of the accuracy and integrity of the manuscript in accordance with ICMJE criteria.

Corresponding author

Correspondence to Sang-Min Park.

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Ethics approval and consent to participate

This study was approved by the institutional review board of our hospital (2022–07-001). Informed consent was obtained from all patients.

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Not applicable.

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The authors declare no competing interests.

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Choi, JY., Park, HJ., Park, SM. et al. Biportal endoscopic discectomy versus tubular microscopic discectomy for treating single-level lumbar disc herniation in obese patients: a multicenter, retrospective analysis. Acta Neurochir 165, 2641–2650 (2023). https://doi.org/10.1007/s00701-023-05686-4

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