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KMID : 1148120230130010001
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Journal of Advanced Spine Surgery
2023 Volume.13 No. 1 p.1 ~ p.9
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What are the Clinical Outcomes of Herniated Intervertebral Discectomy in Obese Patients?: Comparison of Tubular Retractor and Biportal Endoscopy
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Choi Jun-Young
Park Hyun-Jin
Nam Seon-Gyo
Yasuhiro Nakajima
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Abstract
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Background : This study aims to assess the clinical and radiographic outcomes of biportal endoscopic lumbar
discectomy compared to microscopic lumbar discectomy in obese patients with lumbar herniated discs. Previous
research has established a positive correlation between operation time and estimated blood loss in obese patients
undergoing microscopic lumbar discectomy, based on an increase in body mass index. However, no studies have
specifically examined the outcomes of biportal endoscopic lumbar discectomy in this patient population. Therefore,
this study seeks to fill this research gap and provide valuable insights into the effectiveness of these two surgical
approaches for obese patients with lumbar herniated discs.
Methods : This retrospective multicenter study analyzed and compared clinical and radiological data from 48 obese patients with a body mass index (BMI) greater than 30 kg/m2 who underwent either microscopic or biportal endoscopic lumbar discectomy. The study assessed clinical outcomes using the visual analog scale (VAS), Oswestry Disability Index (ODI), and EuroQol-5D (EQ-5D) scores. Radiological data were obtained through magnetic resonance imaging (MRI) scans.
Results: The study included a total of 48 patients, with 31 patients undergoing microscopic discectomy and 17
patients undergoing biportal endoscopic discectomy. Both groups showed improvements in VAS, ODI, and EQ5D scores following surgery compared to preoperative scores. However, there was no significant difference in these outcome measures between the two surgical techniques. Although there was a no significant difference in the occurrence of recurrent disc herniation confirmed by postoperative MRI, there was significant difference in the number of patients requiring additional surgery between the two groups.
Conclusions : For obese patients with lumbar disc herniation that did not respond to conservative treatment, this
study found no significant differences in clinical or radiological outcomes between microscopic and biportal endoscopic surgery methods. However, it is worth noting that the biportal group had a lower incidence of reoperation
compared to the microscopic group.
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KEYWORD
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Obesity, Body mass index, Lumbar disc herniation, Microscopic lumbar discectomy, Biportal endoscopic lumbar discectomy
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