The Comparison of unilateral biportal endoscopic (UBE) and Percutaneous Endoscopic Lumbar Discectomy(PELD) in the Treatment of single-level lumbar disc herniation

Background : The objective of this study was to compare the clinical efficacy of unilateral dual-channel spinal endoscopy (UBE) and percutaneous foraminoscopy (PELD) in the treatment of single-level disc herniation. Patients and Methods: This study recruited patients with lumbar disc herniation who were hospitalized in the spinal surgery Department of Zhaoqing First People's Hospital from January 2021 to December 2023. A total of 51 patients underwent minimally invasive spinal endoscopy, including 23 in the UBE group and 28 in the PELD group.All patients were followed for at least 1 year. Demographic characteristics, Pfirrmann grade, intraoperative and postoperative data, complications and prognostic indicators of intervertebral disc degeneration were analyzed in the two groups. Japanese Orthopaedic Association scores (JOA score), Oswestry disability index (ODI index), visual analog scale (VAS score), and modified macnab criteria were used to evaluate all clinical outcomes. Results: There were no significant differences in demographic characteristics between the two groups, including gender, age, anesthesia ASA score, responsible segment composition, follow-up time and Pfirrmann grade of disc degeneration. PELD was superior to UBE in terms of operation and anesthesia time, blood loss and incision length (p < 0.05), suggesting that PELD is more minimally invasive. However, the intraoperative fluoroscopy of UBE is significantly less than that of PELD (p < 0.05), so that the surgeon receives less radiation. There were no significant differences in the scores of JOA, VAS, ODI and modified Macnab between the two groups after surgery (p > 0.05), but the scores of JOA, VAS, ODI and modified Macnab after surgery in the two groups were improved compared with those before surgery, with significant statistical significance (p < 0.05). Conclusion: UBE and PELD are safe and effective in the treatment of single segment lumbar disc herniation. UBE has a wider intraoperative field of view and more flexible operation. PELD surgery is less invasive, and perioperative recovery is faster, but it is more difficult to operate.