2021 Volume 12 Issue 8 Pages 1074-1080
Introduction: This study aimed to analyze the usefulness of endoscopic lumbar herniotomy by Biportal Endoscopic Spine Surgery (BESS).
Methods: An observational retrospective study was performed. 89 cases (59 males/30 females; average 42 years old) were investigated. 49 cases of lumbar disc herniation (LDH) were treated by BESS. For comparative cases, 40 cases undergone Microscopic surgery (Micro). Examination items are below. Operative time, amount of bleeding, hospitalization period, postoperative pain of postoperative first day and discharge day measured by Numerical rating scale (NRS). We also checked postoperative improvement from preoperative leg pain, numbness and recurrence rate. For comparison between two groups, the Wilcoxon test was used for statistical analysis.
Results: Surgical time of BESS was significantly longer than Micro (77 minutes vs 60 minutes). The mean amount of bleeding during BESS was tend to be less than Micro (7.9 g vs 9.9 g). There was no significant difference in postoperative wound pain at the first day (BESS: 3.7, Micro: 3.6), but tend to less at discharge day (BESS: 1.2, Micro: 1.7). Postoperative improvements of leg pain (BESS: 84%, Micro: 80%) and numbness (BESS: 82%, Micro: 75%) are tend to better in BESS. Recurrence cases are six in each groups.
Conclusions: BESS is two portal surgery which take on a role of camera and working and don't use any cannula and retractor. Normal saline is perfused from camera to working portal to make vision. Thus we can perform surgery with very small incision (5 mm*2). This technic has advantages that we can move camera and surgical instruments more freely. The results of BESS is same as conventional and take it to good option.
