Early Clinical and Radiologic Evaluation of Unilateral Biportal Spinal Endoscopy for Recurrent Lumbar Disc Herniation: A Retrospective Study.

Objective: This study aims to evaluate the changes in radiologic parameters and clinical outcomes associated with the Unilateral biportal endoscopy (UBE) technique for recurrent lumbar disc herniation (rLDH).

Methods: A retrospective study was conducted on 57 patients with rLDH who underwent UBE spinal revision and decompression surgery from 2022 to 2024. Preoperative and postoperative visual analog scale and Oswestry Disability Index scores were collected to assess the impact on activities of daily living. Parameters such as operation time, intraoperative blood loss, postoperative drainage volumes (first and second day), total hospital stay, and postoperative hospital stay were recorded. pre- and postoperative imaging changes in the lumbar spinewere also evaluated. Clinical outcomes were assessed using the MacNab criteria at 6-month follow-up.

Results: No nerve or cauda equina injuries occurred. The mean surgical time was 100.79±20.18 minutes, with a mean intraoperative blood loss of 35.95±14.49 ml. The average drainage volumes were 40.48±14.31 ml on postoperative day 1 and 12.74±8.13 ml on postoperative day 2. No postoperative complications, such as wound infection or dehiscence, were observed. At 6-month follow-up, both VAS and ODI scores were significantly lower than preoperative values (P<0.05). Lumbar CT scans showed a significant increase in spinal canal anteroposterior diameter compared to preoperative measurements (P<0.05). All patients exhibited improvement or resolution of clinical symptoms. The 6-month MacNab functional evaluation revealed excellent results in 21 cases, good in 35 cases, fair in 1 case, resulting in an overall good rate of 98.25%.

Conclusion: The UBE technique showed favorable midterm follow-up results for rLDH surgery, with long-term outcomes warranting further investigation.