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

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-01-17 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1519952

Rongqing Qin, Anhong Guan, Min Zhu, Pin Zhou, Bing Zhou, Ruihua Zhou, Zaiyong Guan

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引用次数: 0

Abstract

Purpose: The 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.

Methods: Seventy-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.

Results: Surgery 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.

Conclusions: We 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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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.