A retrospective study on the efficacy of unilateral biportal endoscopic discectomy treating lumbar disc herniation and concomitant grade I stable degenerative lumbar spondylolisthesis

Abstract

Background: The purpose of this study was to retrospectively assess the clinical and radiographic outcomes of unilateral biportal endoscopic discectomy (UBED) in treating patients with single-level lumbar disc herniation (LDH) and concomitant grade I stable degenerative lumbar spondylolisthesis (DLS). Methods: We reviewed patients diagnosed with single-level LDH and concomitant grade I stable DLS who underwent UBED from June 2021 to June 2023. Preoperative and postoperative slippage percentage, disc height (DH), visual analogue scale (VAS) for back pain and leg radiation pain, and Oswestry disability index (ODI) were compared by a paired-sample test. Demographics and postoperative slip progression were recorded. Results: A total of 32 patients with a mean age of 72.16 ± 8.07 years were enrolled. 27 underwent L4/5 UBED, 4 underwent L5/S1 UBED, and 1 underwent L3/4 UBED. The postoperative mean vertebral slip percentage increased significantly and the mean DH at the surgical level decreased significantly at the last follow-up. VAS scores for back and leg pain reduced significantly after surgery, and ODI scores improved significantly postoperatively. Only one patient suffered postoperative slip progression. Two cases of postoperative cerebrospinal fluid leakage were reported. Conclusions: The application of UBED to treat LDH and concomitant grade I stable DLS demonstrated effective pain relief and improved quality of life for patients, with a low incidence of postoperative slip progression. UBED is a safe and effective surgical technique for treating older patients with LDH and concomitant grade I stable DLS.