Background When obese patients underwent lumbar discectomy using a microscope, a correlation was found between the operation time and an increase in estimated blood loss according to the increase in body mass index.
However, except for minor complications, there was no difference in postoperative outcomes between obese and normal-weight patients. These are the results of microscopic lumbar discectomy in obese patients, but there are no studies on biportal endoscopic lumbar discectomy. The aim of this study was to compare the clinical and radiographic outcomes of microscopic and endoscopic discectomy in obese patients.
Methods Clinical and radiological data were compared and analyzed in 23 obese patients with a body mass index of >30 kg/m2 who underwent microscopic and biportal endoscopic lumbar discectomy. Clinical data on the visual analog scale (VAS), Oswestry Disability Index (ODI), and EuroQol-5D (EQ-5D) scores were measured, and radiological data were measured using magnetic resonance imaging (MRI).
Results In total, 13 patients who underwent microscopic discectomy and 10 who underwent biportal endoscopic discectomy were enrolled in this study. The VAS, ODI, and EQ-5D scores in both groups improved after surgery compared with those before surgery, although there was no difference between the two groups. Although there was a difference in the incidence of recurrent disc herniation confirmed by MRI after surgery, there was no difference in the number of patients requiring surgery between the two groups.
Conclusions There were no significant clinical or radiological differences in outcomes between microscopic and biportal endoscopic surgery methods.