Comparison of clinical efficacy and safety between unilateral biportal endoscopy and percutaneous endoscopic transforaminal discectomy in the treatment of prolapsed and sequestered lumbar disc herniation

Luo Ping; Lei Jiefeng; Hu Bin; Deng Haiyang; Zhou Jiaqing; Zhou Huangjie; Hu Peng; Xiang Zhong; Du Yuxuan

doi:10.3760/j.issn.1673-4777.2026.03.020

Abstract：Objective To compare the clinical efficacy and safety of unilateral biportal endoscopy(UBE)and percutaneous endoscopic transforaminal discectomy(PETD)in the treatment of prolapsed and sequestered lumbar disc herniation.Methods A total of 202 patients with prolapsed and sequestered lumbar disc herniation who underwent surgical treatment in the Fourth Hospital of Changsha from September 2020 to January 2024 were enrolled.According to the surgical method received,the patients were divided into two groups,including 113 cases in the UBE group and 89 cases in the PETD group.The basic clinical data of the two groups were collected,and the operation time,intraoperative blood loss,number of intraoperative X-ray fluoroscopies and postoperative hospital stay were recorded respectively.The pain degree and functional recovery of the two groups were evaluated before surgery as well as at 1 d,3 months and 12 months after surgery,and the evaluation results were statistically analyzed using the visual analogue scale(VAS)score and oswestry disability index(ODI)score.The clinical efficacy of patients was evaluated and graded using the modified Macnab criteria at 3 months and 12 months after surgery.The incidence of postoperative complications in the two groups was recorded and statistically analyzed.Results The operation time and intraoperative blood loss in the UBE group were significantly less than those in the PETD group[(57±10)min vs(64±11)min;(29±8)ml vs(36±9)ml](both P＜0.05).At 3 months after surgery,the excellent and good rate in the UBE group was significantly higher than that in the PETD group[84.1％(95/113)vs 74.2％(66/89)](P=0.033).At 12 months after surgery,there was no statistically significant difference in the excellent and good rate between the two groups(P=0.173).The results of repeated measures analysis of variance showed that there were statistically significant time effects on VAS scores and ODI scores in both groups(both P＜0.001),indicating that overall,the postoperative pain of patients gradually decreased and the function continuously improved with the extension of time.The total incidence of postoperative complications in the UBE group was significantly lower than that in the PETD group[7.1％(8/113)vs 18.0％(16/89)](P=0.038).Conclusion In the treatment of prolapsed and sequestered lumbar disc herniation,UBE has more satisfactory short-term efficacy and higher surgical safety than PETD,while the two surgical methods have similar long-term clinical efficacy.