Clinical outcomes of unilateral biportal endoscopic discectomy for the treatment of far lateral lumbar disc herniation: a retrospective comparative study.

Purpose: This retrospective study aims to evaluate the efficacy and safety of unilateral biportal endoscopic discectomy (UBED) in patients with far lateral lumbar disc herniation (FLLDH).

Methods: A total of 25 patients with single-level FLLDH who underwent UBED between April 2023 and January 2024 were retrospectively analyzed, while 30 patients with paracentral LDH served as the control group. Primary outcomes were assessed using operation time, hospital stay, volume of drainage, complications, postoperative hospitalization duration, visual analogue scale (VAS) scores for back pain (VAS-BP) and leg pain (VAS-LP), the Oswestry Disability Index (ODI), and the modified MacNab criteria. Demographic, symptom-related, and radiographic data were also analyzed.

Results: Preoperative VAS-LP scores were significantly higher in the study group compared to the control group (p < 0.05). In the study group, the ODI, VAS-BP, and VAS-LP scores showed a significant decrease from preoperative values, indicating notable improvement (p < 0.05). Mean operative time was 96.4 min, and mean hospital stay time was 6.44 days. Graded by Macnab criteria, 22 (88%) of patients had good to excellent outcomes. There were no significant differences in complication rates or patient satisfaction between the two groups (p > 0.05). Furthermore, no significant deterioration in disc degeneration and adjacent segment degeneration was observed in either group (p > 0.05).

Conclusion: FLLDH poses significant challenges in both diagnosis and surgical management for surgeons. UBED treatment can yield outcomes comparable to those seen in more common types of LDH, providing a safe and effective treatment for FLLDH with favorable surgical results, minimal complications, and sustained pain relief.