Difference in Efficacy and Indications between UBE and PTED for Single-level Lumbar Disc Herniation

Li Xiangqian; Wu Minghu; Jia Long; Chen Mingji; Chen Nong; Sha Jianjun

Abstract：Objective A prospective study was conducted to compare the efficacy of unilateral biportal endoscopic(UBE)discectomy and percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of single-level lumbar disc herniation.Methods Eighty patients with single-level lumbar disc herniation treated in Qingpu Branch of Zhongshan Hospital between February 2023 and February 2024 were prospectively enrolled.They were randomly allocated into the UBE group[n=40;27 males,13 females;age 26～53 years,mean(42.5±6.8)years]and the PTED group[n=40;22 males,18 females;age 25～54 years,mean(43.2±7.1)years].Operative time,intra-operative fluoroscopy frequency,length of hospital stay,hospitalization cost,and postoperative complications were recorded.Pre-and postoperative assessments included the visual analogue scale(VAS)for pain,Oswestry disability index(ODI),cross-sectional area of the spinal canal,and cross-sectional area of the intervertebral foramen.Results Follow-up lasted 5～8 months,mean(7.1±0.2)months.Operative time and total hospitalization cost in the UBE group were significantly greater than in the PTED group(both P＜0.001).Fluoroscopy frequency and length of hospital stay did not differ between the two groups(P＞0.05).Postoperative complications were comparable(P＞0.05).VAS and ODI improved significantly in both groups after surgery(P＜0.001).At 1 week postoperatively,PTED yielded better VAS and ODI scores than UBE(P＜0.05).At 1 month and 3 months,no significant inter-group differences were observed(P＞0.05).Postoperative cross-sectional area of the spinal canal and intervertebral foramen increased significantly in both groups(P＜0.05).The increase in spinal-canal area was greater in the UBE group than in the PTED group(P＜0.001).Intervertebral-foramen area did not differ between the groups(P＞0.05).Conclusion Both UBE and PTED are effective for single-level lumbar disc herniation.The choice of procedure should be individualized according to patient-specific factors.