Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study

Abstract This study investigated the comparative effectiveness of unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic lumbar discectomy (PELD) in managing lumbar disc herniation (LDH). Clinical data from 146 LDH patients treated surgically at the First Affiliated Hospital of...

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Main Authors: Long Xiao, Jianhong Zhou, Qin Zhong, Xiaobo Zhang, Xuefei Cao
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-99959-w
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author Long Xiao
Jianhong Zhou
Qin Zhong
Xiaobo Zhang
Xuefei Cao
author_facet Long Xiao
Jianhong Zhou
Qin Zhong
Xiaobo Zhang
Xuefei Cao
author_sort Long Xiao
collection DOAJ
description Abstract This study investigated the comparative effectiveness of unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic lumbar discectomy (PELD) in managing lumbar disc herniation (LDH). Clinical data from 146 LDH patients treated surgically at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (January 2020–January 2023) were retrospectively analyzed. Patients were categorized into UBED (n = 84) and PELD (n = 62) groups. Key metrics such as surgical time, incision length, fluoroscopy frequency, blood loss, hospital stay, complications, visual analog scale (VAS) scores, and the Oswestry Disability Index (ODI) were compared. The average age of patients in the UBED group was 53.46 ± 15.60 years, whereas the average age of patients in the PELD group was 55.61 ± 15.52 years (P = 0.411). Their BMI was 24.17 ± 2.94 and 23.90 ± 2.61, respectively (P = 0.558). The duration of symptoms was 10.52 ± 5.23 months in the UBED group and 11.66 ± 6.02 months in the PELD group (P = 0.225). The surgical time was 66.67 ± 15.83 min in the UBED group and 69.11 ± 25.84 min in the PELD group (P = 0.481). Intraoperative blood loss was 76.81 ± 26.74 ml in the UBED group and 69.44 ± 25.74 ml in the PELD group (P = 0.096). The hospital stay was 5.39 ± 1.83 days in the UBED group and 5.11 ± 3.42 days in the PELD group (P = 0.525). The average follow-up time was 16.46 ± 4.52 months in the UBED group and 15.71 ± 3.83 months in the PELD group (P = 0.289). Compared with those before the operation, the VAS score, JOA score, and ODI of both groups significantly improved on the first day postoperatively, at 3 months, and at 6 months. No significant intergroup differences were noted in terms of intraoperative blood loss, hospital stay, or postoperative functional scores. Both groups showed marked postoperative improvements in functional outcomes. The postoperative satisfaction rates of patients in the UBED group and PELD group were 91.7% and 87.1%, respectively. Notably, the UBED group demonstrated a reduced fluoroscopy frequency and significantly lower rates of complications and recurrence. In terms of imaging, the disc Height of the two groups of patients showed a slight decrease after surgery, whereas the spinal canal area increased compared to before surgery, and there was no difference between the groups. UBED and PELD effectively alleviate LDH symptoms, but UBED has advantages in reducing fluoroscopy dependence, complications, and recurrence.
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spelling doaj-art-2f2d52e6ad924cfca0ca96421ffcb7db2025-08-20T01:48:50ZengNature PortfolioScientific Reports2045-23222025-05-011511810.1038/s41598-025-99959-wClinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective studyLong Xiao0Jianhong Zhou1Qin Zhong2Xiaobo Zhang3Xuefei Cao4Department of Orthopedics, the First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineDepartment of Orthopedics, the First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineClinical Medical Research Center, Affiliated Hospital of Guizhou Medical UniversityDepartment of Orthopedics, Honghui Hospital, Xi’an Jiaotong UniversityDepartment of Orthopedics, Honghui Hospital, Xi’an Jiaotong UniversityAbstract This study investigated the comparative effectiveness of unilateral biportal endoscopic discectomy (UBED) and percutaneous endoscopic lumbar discectomy (PELD) in managing lumbar disc herniation (LDH). Clinical data from 146 LDH patients treated surgically at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (January 2020–January 2023) were retrospectively analyzed. Patients were categorized into UBED (n = 84) and PELD (n = 62) groups. Key metrics such as surgical time, incision length, fluoroscopy frequency, blood loss, hospital stay, complications, visual analog scale (VAS) scores, and the Oswestry Disability Index (ODI) were compared. The average age of patients in the UBED group was 53.46 ± 15.60 years, whereas the average age of patients in the PELD group was 55.61 ± 15.52 years (P = 0.411). Their BMI was 24.17 ± 2.94 and 23.90 ± 2.61, respectively (P = 0.558). The duration of symptoms was 10.52 ± 5.23 months in the UBED group and 11.66 ± 6.02 months in the PELD group (P = 0.225). The surgical time was 66.67 ± 15.83 min in the UBED group and 69.11 ± 25.84 min in the PELD group (P = 0.481). Intraoperative blood loss was 76.81 ± 26.74 ml in the UBED group and 69.44 ± 25.74 ml in the PELD group (P = 0.096). The hospital stay was 5.39 ± 1.83 days in the UBED group and 5.11 ± 3.42 days in the PELD group (P = 0.525). The average follow-up time was 16.46 ± 4.52 months in the UBED group and 15.71 ± 3.83 months in the PELD group (P = 0.289). Compared with those before the operation, the VAS score, JOA score, and ODI of both groups significantly improved on the first day postoperatively, at 3 months, and at 6 months. No significant intergroup differences were noted in terms of intraoperative blood loss, hospital stay, or postoperative functional scores. Both groups showed marked postoperative improvements in functional outcomes. The postoperative satisfaction rates of patients in the UBED group and PELD group were 91.7% and 87.1%, respectively. Notably, the UBED group demonstrated a reduced fluoroscopy frequency and significantly lower rates of complications and recurrence. In terms of imaging, the disc Height of the two groups of patients showed a slight decrease after surgery, whereas the spinal canal area increased compared to before surgery, and there was no difference between the groups. UBED and PELD effectively alleviate LDH symptoms, but UBED has advantages in reducing fluoroscopy dependence, complications, and recurrence.https://doi.org/10.1038/s41598-025-99959-wLumbar disc herniation (LDH)Unilateral biportal endoscopic discectomy (UBED)Percutaneous endoscopic lumbar discectomy (PELD)Minimally invasive spine surgery
spellingShingle Long Xiao
Jianhong Zhou
Qin Zhong
Xiaobo Zhang
Xuefei Cao
Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
Scientific Reports
Lumbar disc herniation (LDH)
Unilateral biportal endoscopic discectomy (UBED)
Percutaneous endoscopic lumbar discectomy (PELD)
Minimally invasive spine surgery
title Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
title_full Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
title_fullStr Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
title_full_unstemmed Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
title_short Clinical comparison of percutaneous endoscopic interlaminar vs. unilateral biportal endoscopic discectomy for lumbar disc herniation: a retrospective study
title_sort clinical comparison of percutaneous endoscopic interlaminar vs unilateral biportal endoscopic discectomy for lumbar disc herniation a retrospective study
topic Lumbar disc herniation (LDH)
Unilateral biportal endoscopic discectomy (UBED)
Percutaneous endoscopic lumbar discectomy (PELD)
Minimally invasive spine surgery
url https://doi.org/10.1038/s41598-025-99959-w
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