Outcomes of Unilateral Biportal Endoscopic Surgery for Prolapsed Intervertebral Disc: A Single-center Study

Introduction: Unilateral biportal endoscopic surgery (UBES) has emerged as a promising minimally invasive technique for treating lumbar spine disorders. However, a comprehensive evaluation of its long-term outcomes still needs to be improved. Aims and Objectives: This prospective study aimed to evaluate the efficacy and safety of posterior decompression for lumbar disc prolapse done by unilateral biportal endoscopy (UBE), including neurological improvement, functional status, and complications. Materials and Methods: Consecutive patients undergoing UBES were included from a tertiary care center, Hamidia Hospital, associated with Gandhi Medical College, Bhopal, Madhya Pradesh. Demographic data, pre-operative clinical characteristics, and surgical details were collected. Neurological improvement was assessed at preoperative, 2 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively. Functional assessment using Visual Analog Scale (VAS) scores, Oswestry disability index (ODI), and Macnab criteria was performed at pre-operative, 2 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively at each follow-up visit. Results: 50 patients of lumbar disc prolapse (66% male and 34% female) with a mean age of 40.38 ± 9.76 were enrolled, who underwent posterior decompression by UBE surgeries, most performed at L4-L5 (42%) and L5-S1 (40%) levels. Neurological status significantly improved postoperatively, with sustained enhancement in 1 year (96% improvement). Functional assessment revealed significant reductions in ODI scores (from 84.52 ± 4.04 preoperatively to 14.18 ± 3.2 [P = 0.001] at 1 year), VAS scores for back and leg pain (from 8.40 ± 0.756 preoperatively to 0.40 ± 0.495 [P = 0.001] at 1 year), and Macnab criteria outcomes as excellent at 1 year in 96% of patients. Conclusion: UBES demonstrates favorable outcomes for lumbar disc prolapse on 1-year follow-up, including neurological improvement, pain relief, and functional outcomes. UBES represents a promising minimally invasive approach for treating lumbar spine disorders, potentially enhancing patient quality of life.