Comparison of the therapeutic effects of unilateral biportal endoscopic discectomy and percutaneous endoscopic interlaminar discectomy in the treatment of lumbar disc herniation

Objectives Over recent years, minimally invasive spine surgery has seen rapid advancement, with Unilateral Biportal Endoscopy (UBE) and Percutaneous Endoscopic Interlaminar Discectomy (PEID) emerging as increasingly important techniques for the treatment of lumbar disc herniation. The UBE technique involves the creation of two small incisions on one side of the patient's spine, offering flexibility and precision during surgery. In contrast, the PEID technique establishes a working channel through percutaneous puncture, performing the procedure under endoscopic visualization. Although both techniques are increasingly adopted, comparative studies remain limited. This study aims to compare the clinical efficacy of UBE and PEID in the management of lumbar disc herniation, with the goal of providing clinicians with more evidence-based treatment options. Methods A total of 117 patients diagnosed with lumbar disc herniation were treated at three spinal centers: Linqu County People's Hospital, Hangzhou Traditional Chinese Medicine Hospital, and Qingdao University Affiliated Hospital, between April 2023 and March 2024. Based on the surgical technique chosen, patients were divided into two groups: the UBE group (52 patients undergoing Unilateral Biportal Endoscopy) and the PEID group (65 patients undergoing Percutaneous Endoscopic Interlaminar Discectomy). Various surgical parameters, including operative time, blood loss, complication rates, X-ray exposure, and other clinical outcomes, were compared between the two groups. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were evaluated preoperatively, and at 1 and 6 months postoperatively. Additionally, the cross-sectional area of the dural sac was measured preoperatively and 1 month postoperatively. Results Baseline characteristics, including age, gender, and duration of symptoms, were comparable between the two groups ( P >0.05). For patients undergoing unilateral decompression, there was no significant difference in operative time between the two groups ( P >0.05). However, for patients requiring bilateral decompression, the UBE group demonstrated significantly shorter operative times compared to the PEID group ( P <0.05). Intraoperative blood loss, length of hospitalization, X-ray exposure, and complication rates did not differ significantly between the two groups ( P >0.05). Nevertheless, the UBE group incurred significantly higher hospitalization costs than the PEID group ( P <0.05). Postoperatively, both groups showed significant improvements in VAS scores ( P < 0.05) and ODI scores ( P <0.05), with a notable increase in the cross-sectional area of the dural sac ( P <0.05). Additionally, the UBE group exhibited a larger postoperative cross-sectional area of the dural sac compared to the PEID group ( P <0.05). Conclusions Both UBE and PEID are effective techniques for treating lumbar disc herniation. For patients with unilateral symptoms, both methods yield comparable outcomes, with PEID associated with lower hospitalization costs. For patients with bilateral symptoms, UBE offers a shorter operative time and superior postoperative outcomes.