Comparison of clinical efficacy and facet joint invasiveness between unilateral biportal endoscopic and percutaneous endoscopic lumbar discectomy treatment of calcified lumbar disc herniation: a retrospective analysis

Background Comparing the clinical efficacy and lumbar facet invasiveness of percutaneous endoscopic lumbar discectomy (PELD) and unilateral biportal endoscopic (UBE) treatment for calcified lumbar disc herniation (CLDH), providing new ideas for spinal surgeons to treat CLDH. Methods A retrospective analysis was conducted on the data of 49 CLDH patients who underwent intervertebral disc resection surgery in our hospital from January 2016 to August 2024, including 20 who underwent PELD surgery and 29 who underwent UBE surgery. The demographic, clinical, and surgical outcomes of the two groups of patients were collected and analyzed. Results All surgeries were completed successfully, with significant improvement in clinical symptoms observed in both groups postoperatively. The PELD group required an average of 5.52 more fluoroscopy frequency than the UBE group. The average operative time in the PELD group was 9.21 minutes shorter than in the UBE group. The mean pre-to-postoperative hemoglobin difference was 3.65 g/L lower in the PELD group than in the UBE group. The mean preservation rate of Lumbar Facet was 9.10% higher in the PELD group than in the UBE group. These differences were statistically significant (P < 0.05). The excellent-to-good rate was 90.00% in the PELD group and 93.10% in the UBE group. Additionally, two patients in the PELD group experienced complications, and two patients had recurrence at 12 months postoperatively; however, none resulted in severe consequences. No complications or postoperative recurrences were observed in the UBE group. Conclusions Both PELD and UBE are effective methods for the treatment of CLDH, but the surgical approach should be selected based on the actual conditions of patients. For patients with complex disc calcification, UBE is recommended.