Comparing the Large Channel Endoscopic and Systems with Full Endoscopic Visualization Technique inter laminar approach for single- segment disc herniation on neurological function: a randomised controlled trial

Abstract

Abstract Objective Comparison of the iLESSYS Delta with the Endo-Surgi Plus for PEID treatment of L5-S1LDH on neurological function. Methods In the period from August 2021 to August 2022, 80 patients with LDH in the L5-S1 segment were treated with PEID using the iLESSYS Delta system or the Endo-Surgi Plus system in combination with INOM and cervical EP monitoring. Patients were classified into two groups based on the endoscopy system employed. Of these,37patients were included in the Delta group and 43 patients in the Plus group.Patient demographics, perioperative indicators, IONM indicators, intraoperative EP and complications were analysed.Clinical outcomes were quantified using back and leg visual analog scale(VAS) scores, Oswestry Disability Index(ODI) and Japanese orthopaedic association(JOA) scores at the time points of follow-up.Patient satisfaction was assessed at the final follow-up according to the modified MacNab criteria. Results In the Plus group, the duration of surgery and the number of arthroplasties were less than those in the Delta group, with a statistically significant difference (p < 0.05). The rates of abnormal IONM indicators,cervical EP at the end of surgery and maximum intraoperative EP in the Plus group were less than those in the Delta group, with a statistically significant difference (p < 0.001). Compared to the preoperative period, the VAS score, ODI and JOA scores improved in both groups at all follow-up time points, and the difference was statistically significant (p < 0.001); The differences in pain VAS scores, ODI and JOA scores were not statistically significant when comparing the two groups (p > 0.05). Conclusion Both the iLESSYS Delta and Endo-Surgi Plus surgical systems achieve satisfactory early clinical results in the treatment of LDH with the Endo-Surgi Plus surgical shaping being more efficient, with less intraoperative impact on neurological function and safer.