Delta large-channel endoscopic discectomy versus Unilateral biportal endoscopic discectomy in the treatment of lumbar disc herniation: A Retrospective Study

OBJECTIVE To compare the clinical efficacy and safety of two posterior minimally invasive surgeries using percutaneous interlaminar approach: Delta large-channel endoscopic discectomy(DLED) versus Unilateral biportal endoscopic discectomy(UBED) in the treatment of lumbar disc herniation(LDH). METHODS A retrospective analysis was conducted on 74 LDH patients treated with DLED(39 cases) and UBED(35 cases) from January 2023 to January 2024. Observe the operation time, number of fluoroscopy, intraoperative blood loss(IBL), total blood loss(TBL), hidden blood loss(HBL), and postoperative hemoglobin(HB), hematocrit(HCT), and creatine kinase (CK)levels. At the same time, the clinical efficacy was evaluated using the pain visual analog scale(VAS), Oswestry Disability Index(ODI) and modified Macnab assessment criteria. Result Compared with DLED group, UBED group was associated with longer operation time, more Hb loss, more Hct loss, and higher CK level ( P  < 0.05) . Additionally, IBL, TBL, and HBL in the DLED group were less than those in the UBED group ( P < 0.05). Postoperative VAS scores and ODI scores showed significant decreases in both groups compared to preoperative scores ( P < 0.05). However, there was no significant difference in VAS and ODI scores between the two groups at 1 day 、3 months、 6 months postoperatively ( P > 0.05). Additionally, no notable differences were observed in the modified MacNab criteria. CONCLUSION UBED and DLED are two minimally invasive techniques that have demonstrated significant effectiveness and safety in the treatment of LDH. However, the DLED group exhibits certain advantages over the UBED group, particularly regarding operation time, blood loss, and soft tissue damage.