Emerging Spine Care Trends and Innovations

Comparing the Efficacy and Safety of Unilateral Biportal Endoscopic Decompression with Percutaneous Endoscopic Lumbar Decompression for Lumbar Degenerative Diseases: A Meta-Analysis

OBJECTIVE

Unilateral biportal endoscopic decompression (UBED) offers the advantages of minimal tissue damage, operational flexibility, and clear visualization, positioning it as an innovative and minimally invasive endoscopic technique. Nevertheless, the clinical evidence supporting the use of UBED in the treatment of degenerative lumbar diseases is limited and conflicting.

METHODS

As of October 1, 2023, a comprehensive search was conducted across databases including Web of Science, PubMed, Embase, and the Cochrane Library to identify all published studies on minimally invasive UBED for the treatment of degenerative lumbar diseases. Data pertaining to patient demographics, fluoroscopy time, operative duration, intraoperative hemorrhage, hospitalization length, visual analog scale (VAS) score for back and leg pain, MacNab criteria, Oswestry Disability Index (ODI), and complication rates were extracted. The Newcastle-Ottawa scale was utilized to assess the quality.

RESULTS

Twelve articles were included, involving 816 patients. The back VAS score (95% confidence interval [CI]: -0.09-0.07, P = 0.75), MacNab criteria (95% CI: 0.52-2.3, P = 0.82), fluoroscopy time (95% CI: -7.03 to -0.4, P = 0.08), and the incidence of complications (95% CI: 0.5-1.73, P = 0.82) were not significantly different, while the leg VAS score (95% CI: 0.01-0.18, P = 0.03), ODI score (95% CI: -1.03 to -0.09, P = 0.02), operation time (95% CI: 5.76-20.62, P = 0.0005), hospitalization length (95% CI: 0.41-2.76, P = 0.008), and intraoperative hemorrhage (95% CI: 21.92-72.44, P = 0.0003) were significantly different.

CONCLUSIONS

UBED offers superiority in ODI, flexibility, and visual field clarity. Conversely, percutaneous endoscopic lumbar decompression presents advantages in terms of operation duration, blood loss, hospitalization length, and leg VAS score. These factors should be thoroughly considered when selecting a surgical approach.

Perioperative Nursing of Vitrectomy for Ocular Trauma under the Guidance of Ophthalmoscope

To explore the perioperative nursing methods and clinical effects of vitrectomy under ophthalmoscope in the treatment of severe ocular rupture, this study reviews the clinical effects of vitrectomy in the treatment of severe ocular trauma in China, analyzes the perioperative nursing of vitrectomy for ocular trauma under the guidance of an ophthalmoscope, and analyzes the importance of stage I debridement and suture, the choice of operation time, and the advantages of vitrectomy and perioperative nursing care. The retrospective analysis of these data shows that the clinical effect of peri-vitrectomy for ocular trauma under the guidance of an ophthalmoscope is accurate, and surgical treatment should be carried out as soon as possible according to the patient's condition, which can reduce the complications of suppurative ophthalmitis, eyeball atrophy, and vitreous rebleeding. Perioperative nursing intervention is beneficial to the recovery of visual acuity in patients with severe ocular rupture treated by vitrectomy under the ophthalmoscope, which is worthy of clinical promotion.