Clinical Study on the Effect of UBE and BEIS Techniques in Treating L5S1 Lumbar Disc Herniation and Their Impact on Postoperative Lumbar Stability

Liu Xingming; Chen Huan; You Dongchun; Guo Weifeng; Wu Ronghai; Zheng Zhouhang; Zhang Yu

Abstract：Objective To compare the clinical efficacy and postoperative lumbar stability of unilateral biportal endoscopy(UBE)and BEIS(broad,easy,immediate,surgery)techniques in the treatment of L5S1 lumbar disc herniation.Methods Retrospective analysis was conducted on the data of 120 patients with L5S1 lumbar disc herniation admitted to the Orthopaedics Department of Guangdong Second Traditional Chinese Medicine Hospital from October 2021 to March 2023.In the UBE group,there were 29 males and 29 females;the age ranged from 26 to 66 years old,with an average of(42.54±7.50)years.In the BEIS group,there were 30 males and 32 females;the age range was 28 to 68 years old,with an average of(43.15±7.14)years.The differences in surgical time,fluoroscopy frequency,intraoperative blood loss,hospital stay,visual analogue scale(VAS),Oswestry disability index(ODI),paraspinal muscle fat infiltration rate,lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT)were compared between the two groups.Results The BEIS group had an average surgical time of(70.08±13.41)min,an average fluoroscopy frequency of(11.47±1.40)times,and an average intraoperative blood loss of(12.74±7.89)mL.The UBE group had an average surgical time of(60.45±16.82)min,an average fluoroscopy frequency of(4.58±1.23)times,and an average intraoperative blood loss of(28.45±8.47)mL.The UBE group was superior to the BEIS group in terms of surgical time and fluoroscopy frequency,but had more intraoperative blood loss than the BEIS group(P＜0.05).The UBE group was followed up for 12～14 months,with an average follow-up time of(12.10±0.10)months.The BEIS group was followed up for 12～15 months,with an average follow-up time of(13.20±0.10)months.At 12 months after surgery,the BEIS group had an average VAS score of(2.23±1.32)and an average ODI score of(8.98±3.47)％.The UBE group had an average VAS score of(2.91±0.98)and an average ODI score of(11.62±3.51)％.The clinical symptoms of the BEIS group were better than those of the UBE group at 12 months after surgery(P＜0.05).In terms of fat infiltration rate,the BEIS group had a rate of(36.05±3.95)％at 12 months after surgery,while the UBE group had a rate of(38.12±2.98)％.The BEIS group showed a more significant improvement than the UBE group(P＜0.05).At 12 months after surgery,the BEIS group had LL,PT,and SS of(41.05±3.95)°,(15.05±4.05)°,and(38.05±4.09)°,respectively.The UBE group had LL,PT,and SS of(37.17±2.15)°,(18.87±2.77)°,and(35.87±3.51)°,respectively.Compared with the UBE group,the BEIS group had larger LL and SS angles and a smaller PT angle(P＜0.05).Two patients in the UBE group had postoperative lower limb pain,and one patient in the BEIS group had postoperative lower limb pain,which were relieved after symptomatic treatment.Conclusion Both UBE and BEIS techniques are safe and effective in treating L5S1 lumbar disc herniation.However,BEIS technique has certain advantages in terms of early postoperation spinal stability of patients after surgery.