A new retrospective cohort study compares outcomes for patients who are treated with tubular lumbar microdiscectomy to patients who are treated with a single-level unilateral biportal endoscopic microdiscectomy—an emerging type of minimally-invasive spine surgery.
The outcomes are revealed and detailed in a new study: “Single-Level Unilateral Biportal Endoscopic versus Tubular Microdiscectomy: Comparing Surgical Outcomes and Opioid Consumption,” which appears in the September 19, 2024 edition of World Neurosurgery.
According to the study authors, unilateral biportal endoscopy is a novel technique for treatment of lumbar stenosis and disc herniation that involves placement of same-sided viewing and working endoscopic portals for augmented visualization and flexibility.
The NYU Langone research team, citing limited outcome data in the literature, enrolled 102 patients in the study—48 who had single-level unilateral biportal endoscopic microdiscectomy and 54 who had tubular lumbar microdiscectomy.
Opioid Use Drops 21% With Endoscopic Spine Surgery
The team found that endoscopic spine surgery reduced patient use of opioids by 21% immediately following surgery when compared to tubular lumbar microdiscectomy, which is a more invasive approach. Patient use of non-opioid pain medication was marginally reduced, by 2%.
“This breakthrough technique is a game changer because it gives patients a better recovery with less pain and less need for narcotics and their related side-effects,” said Charla R. Fischer, M.D., co-director of the Endoscopic Spine Surgery Program at NYU Langone Orthopedics and lead author on the study. “This is a highly-specialized area, and we are leading in the number of cases performed because we’ve seen the benefit this brings to our patients and their recovery.”
The Endoscopic Spine Surgery Program is housed in the NYU Langone Spine Center. The authors note that it is one of only a few such facilities in the United States—and that they are leading the way in creating treatment guidelines that ensure the safe and responsible use of new endoscopic techniques for spine surgery while allowing surgeons to provide the highest quality of care and the best possible outcomes for NYU Langone patients.
OTW asked Dr. Fischer to describe how widespread unilateral biportal endoscopic discectomy is in the United States. “Although the use of this procedure is very widespread in certain parts of the world, it is relative infancy in the United States as there are very few centers that offer this surgical technique,” she said.
“As is with some other technologies, there are other countries that are very innovative and embrace certain techniques. They have the proper learning structures to help surgeons ease through the learning curve, which we seem to lack due to the stringent medical-legal environment. This is why it is so important for academic medical centers like NYU Langone Health to take the lead in new technologies to train the next generation of spine surgeons.”
The researchers look forward to future studies with larger sample sizes and prospective designs that can further inform the long-term outcomes of endoscopic spine surgery compared to other minimally invasive spine surgical procedures.
