Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study

This study investigated the comparative effectiveness of unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic lumbar discectomy (PELD) in managing lumbar disc herniation (LDH). Clinical data from 146 LDH patients treated surgically at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (January 2020-January 2023) were retrospectively analyzed. Patients were categorized into UBED (n = 84) and PELD (n = 62) groups. Key metrics such as surgical time, incision length, fluoroscopy frequency, blood loss, hospital stay, complications, visual analog scale (VAS) scores, and the Oswestry Disability Index (ODI) were compared. The average age of patients in the UBED group was 53.46 ± 15.60 years, whereas the average age of patients in the PELD group was 55.61 ± 15.52 years (P = 0.411). Their BMI was 24.17 ± 2.94 and 23.90 ± 2.61, respectively (P = 0.558). The duration of symptoms was 10.52 ± 5.23 months in the UBED group and 11.66 ± 6.02 months in the PELD group (P = 0.225). The surgical time was 66.67 ± 15.83 min in the UBED group and 69.11 ± 25.84 min in the PELD group (P = 0.481). Intraoperative blood loss was 76.81 ± 26.74 ml in the UBED group and 69.44 ± 25.74 ml in the PELD group (P = 0.096). The hospital stay was 5.39 ± 1.83 days in the UBED group and 5.11 ± 3.42 days in the PELD group (P = 0.525). The average follow-up time was 16.46 ± 4.52 months in the UBED group and 15.71 ± 3.83 months in the PELD group (P = 0.289). Compared with those before the operation, the VAS score, JOA score, and ODI of both groups significantly improved on the first day postoperatively, at 3 months, and at 6 months. No significant intergroup differences were noted in terms of intraoperative blood loss, hospital stay, or postoperative functional scores. Both groups showed marked postoperative improvements in functional outcomes. The postoperative satisfaction rates of patients in the UBED group and PELD group were 91.7% and 87.1%, respectively. Notably, the UBED group demonstrated a reduced fluoroscopy frequency and significantly lower rates of complications and recurrence. In terms of imaging, the disc Height of the two groups of patients showed a slight decrease after surgery, whereas the spinal canal area increased compared to before surgery, and there was no difference between the groups. UBED and PELD effectively alleviate LDH symptoms, but UBED has advantages in reducing fluoroscopy dependence, complications, and recurrence.