Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients

PurposeThe purpose of this study is to investigate the surgical efficacy and safety of percutaneous unilateral biportal endoscopic discectomy (UBED) for symptomatic lumbar disc herniation (LDH) in geriatric patients.MethodsSeventy-two geriatric patients, aged 65–86 years (mean age: 73.2 years), with...

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Main Authors: Rongqing Qin, Anhong Guan, Min Zhu, Pin Zhou, Bing Zhou, Ruihua Zhou, Zaiyong Guan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2024.1519952/full
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author Rongqing Qin
Rongqing Qin
Anhong Guan
Anhong Guan
Min Zhu
Pin Zhou
Bing Zhou
Bing Zhou
Ruihua Zhou
Ruihua Zhou
Zaiyong Guan
Zaiyong Guan
author_facet Rongqing Qin
Rongqing Qin
Anhong Guan
Anhong Guan
Min Zhu
Pin Zhou
Bing Zhou
Bing Zhou
Ruihua Zhou
Ruihua Zhou
Zaiyong Guan
Zaiyong Guan
author_sort Rongqing Qin
collection DOAJ
description PurposeThe purpose of this study is to investigate the surgical efficacy and safety of percutaneous unilateral biportal endoscopic discectomy (UBED) for symptomatic lumbar disc herniation (LDH) in geriatric patients.MethodsSeventy-two geriatric patients, aged 65–86 years (mean age: 73.2 years), with single or two-level LDH who underwent UBED from January 2020 to September 2022 were retrospectively analyzed. Clinical outcomes were evaluated based on operation time, total blood loss, hospital stay, visual analog scale (VAS) scores for leg pain, Oswestry disability index (ODI) scores, modified MacNab criteria, and postoperative magnetic resonance imaging findings.ResultsSurgery was successfully performed on all geriatric patients, with a mean operation time of 46 min (range: 32–68 min). All patients were followed up for an average duration of 14.2 ± 1.9 months (range: 12–16 months). The leg pain VAS score decreased from 8.37 ± 1.21 preoperatively to 2.03 ± 0.61 immediately after surgery, 1.56 ± 0.32 at 1 month postoperatively, 1.16 ± 0.45 at 6 months postoperatively, and 0.91 ± 0.26 at 12 months postoperatively. Similarly, the ODI score also decreased from 61.21 ± 11.06 preoperatively to 27.52 ± 10.41 immediately after surgery, 19.12 ± 7.05 at 1 month postoperatively, 12.17 ± 5.21 at 6 months postoperatively, and 8.56 ± 4.32 at 12 months postoperatively. Statistically significant differences were observed in both VAS and ODI scores at each follow-up time point when compared with preoperative parameters (P < 0.01). Also, there were 53 excellent cases, 12 good cases, and 7 fair cases based on the modified MacNab criteria at 12 months postoperatively, resulting in an excellent and good rate of 90.2%. Only three cases were found to be complicated by low extremity numbness, all of which were recovered via conservative treatment in 3 weeks. No infections or iatrogenic neurological deficits occurred in all patients.ConclusionsWe concluded that UBED achieved satisfactory results and provided a minimally invasive, effective, and safe alternative for the treatment of symptomatic LDH in geriatric patients.
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spelling doaj-art-361e720d65bb45c991c533533612b88a2025-01-17T06:50:58ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011110.3389/fsurg.2024.15199521519952Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patientsRongqing Qin0Rongqing Qin1Anhong Guan2Anhong Guan3Min Zhu4Pin Zhou5Bing Zhou6Bing Zhou7Ruihua Zhou8Ruihua Zhou9Zaiyong Guan10Zaiyong Guan11Department of Spinal Surgery, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, The Third Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Spinal Surgery, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, The Third Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Medical Image, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, Gaoyou Hospital of Integrated Traditional Chinese and Western Medicine, Yangzhou, Jiangsu, ChinaDepartment of Spinal Surgery, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, The Third Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Spinal Surgery, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, The Third Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, ChinaDepartment of Spinal Surgery, Gaoyou People’s Hospital, Yangzhou, Jiangsu, ChinaDepartment of Orthopedics, The Third Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, ChinaPurposeThe purpose of this study is to investigate the surgical efficacy and safety of percutaneous unilateral biportal endoscopic discectomy (UBED) for symptomatic lumbar disc herniation (LDH) in geriatric patients.MethodsSeventy-two geriatric patients, aged 65–86 years (mean age: 73.2 years), with single or two-level LDH who underwent UBED from January 2020 to September 2022 were retrospectively analyzed. Clinical outcomes were evaluated based on operation time, total blood loss, hospital stay, visual analog scale (VAS) scores for leg pain, Oswestry disability index (ODI) scores, modified MacNab criteria, and postoperative magnetic resonance imaging findings.ResultsSurgery was successfully performed on all geriatric patients, with a mean operation time of 46 min (range: 32–68 min). All patients were followed up for an average duration of 14.2 ± 1.9 months (range: 12–16 months). The leg pain VAS score decreased from 8.37 ± 1.21 preoperatively to 2.03 ± 0.61 immediately after surgery, 1.56 ± 0.32 at 1 month postoperatively, 1.16 ± 0.45 at 6 months postoperatively, and 0.91 ± 0.26 at 12 months postoperatively. Similarly, the ODI score also decreased from 61.21 ± 11.06 preoperatively to 27.52 ± 10.41 immediately after surgery, 19.12 ± 7.05 at 1 month postoperatively, 12.17 ± 5.21 at 6 months postoperatively, and 8.56 ± 4.32 at 12 months postoperatively. Statistically significant differences were observed in both VAS and ODI scores at each follow-up time point when compared with preoperative parameters (P < 0.01). Also, there were 53 excellent cases, 12 good cases, and 7 fair cases based on the modified MacNab criteria at 12 months postoperatively, resulting in an excellent and good rate of 90.2%. Only three cases were found to be complicated by low extremity numbness, all of which were recovered via conservative treatment in 3 weeks. No infections or iatrogenic neurological deficits occurred in all patients.ConclusionsWe concluded that UBED achieved satisfactory results and provided a minimally invasive, effective, and safe alternative for the treatment of symptomatic LDH in geriatric patients.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1519952/fullunilateral biportal endoscopic discectomylumbar disc herniationminimally invasivegeriatricspine surgery
spellingShingle Rongqing Qin
Rongqing Qin
Anhong Guan
Anhong Guan
Min Zhu
Pin Zhou
Bing Zhou
Bing Zhou
Ruihua Zhou
Ruihua Zhou
Zaiyong Guan
Zaiyong Guan
Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
Frontiers in Surgery
unilateral biportal endoscopic discectomy
lumbar disc herniation
minimally invasive
geriatric
spine surgery
title Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
title_full Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
title_fullStr Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
title_full_unstemmed Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
title_short Percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
title_sort percutaneous unilateral biportal endoscopic discectomy for symptomatic lumbar disc herniation in geriatric patients
topic unilateral biportal endoscopic discectomy
lumbar disc herniation
minimally invasive
geriatric
spine surgery
url https://www.frontiersin.org/articles/10.3389/fsurg.2024.1519952/full
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