Comparing the efficacy and safety of biportal endoscopic discectomy with microscopic discectomy for lumbar herniated intervertebral disc: a multicentre, prospective, assessor-blinded, randomized controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(13):29 Bone Joint J . 2025 May 1;107-B(5):529-539.What this means for my practice?
BED provides equivalent functional outcomes to MD in treating single-level lumbar disc herniation, with added benefits such as reduced early pain, better scar appearance, and fewer wound complications. This supports its role as a minimally invasive, effective alternative in surgical practice. However, the findings are limited by a short 12-month follow-up and lack of data on analgesic use and long-term outcomes.
Study Summary
One hundred patients with single-level lumbar disc herniation were randomized to receive either biportal endoscopic discectomy (BED; n = 50) or microscopic discectomy (MD; n = 50). The primary outcome of interest was the Oswestry Disability Index (ODI) at 12 months. Secondary outcomes included surgical site pain, scar appearance (POSAS), serum creatine phosphokinase (CPK) ratio, and rates of wound complications. Outcomes were assessed at 2 weeks, 3 months, 6 months, and 12 months. Overall, the results of the study revealed that ODI scores were equivalent between the two groups at 12 months. BED was associated with reduced early postoperative pain, better cosmetic scarring, lower CPK levels, and fewer wound dehiscence events. These findings support BED as a safe and effective alternative to MD, offering added benefits from its minimally invasive approach.
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