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Purpose <p>Lumbar disc herniation (LDH), a prevalent cause of pain and disability specifically in adults, is treated with minimally invasive techniques like Percutaneous Endoscopic Lumbar Discectomy (PELD) and Unilateral Biportal Endoscopic Discectomy (UBED). The meta-analysis aims to compare the efficacy and procedural efficiency of UBED and PELD.</p> Methods <p>PubMed, Cochrane Central, and ScienceDirect were searched till May 2025. Risk ratios (RRs) and mean differences (MDs) were pooled under the random effects model using the Review Manager software version 5.4.1. Quality assessment was performed using the Newcastle-Ottawa Scale. Subgroup analysis was performed based on PELD subtypes: percutaneous transforaminal endoscopic discectomy (PTED) and percutaneous endoscopic interlaminar discectomy (PEID).</p> Results <p>Twenty-three studies, pooling 2,271 patients, were included in this meta-analysis. UBED was associated with significantly increased procedural duration (MD = 12.91; 95%CI: [7.71,18.12]; <i>p</i> &lt; 0.00001) and hospitalization (MD = 1.21; 95%CI: [0.44, 1.97]; <i>p</i> = 0.002) though it decreased the LDH recurrence (RR = 0.31; 95%CI: [0.14, 0.68]; <i>p</i> = 0.003) when compared to PELD. PTED was the only technique associated with favourable hospitalization duration and Visual analog scale (VAS) back score as UBED increased these endpoints in the subgroup analysis (MD = 1.54; 95%CI: [0.38, 2.70]; <i>p</i> = 0.009) and (MD = 0.31; 95%CI: [0.08, 0.54]; <i>p</i> = 0.009), respectively. PEID was the only technique associated with favourable ODI scores, as UBED increased this endpoint in subgroup analysis (MD = 1.31; 95% CI: [0.12, 2.49]; <i>p</i> = 0.03). Additionally, PEID demonstrated comparable efficacy to UBED in terms of LDH recurrence (RR = 0.58; 95% CI: [0.20, 1.65]; <i>p</i> = 0.31).</p> Conclusion <p>UBED may have longer operative time and hospital stay, but may show fewer LDH recurrences than PELD. PTED may show favourable hospitalization duration and VAS back scores, while PEID may show favourable ODI scores and similar recurrence rates to UBED.</p>

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Comparing unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy for single-level lumbar disc herniation: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年3月25日

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  • Muhammad Hassan Waseem,
  • Zain ul Abideen,
  • Soha Abbas,
  • Muhammad Siddiq,
  • Isha Atiq,
  • Zunera Huda,
  • Muhammad Meeran Saleem,
  • Pawan Kumar Thada,
  • Brandon Lucke-Wold

摘要

Purpose

Lumbar disc herniation (LDH), a prevalent cause of pain and disability specifically in adults, is treated with minimally invasive techniques like Percutaneous Endoscopic Lumbar Discectomy (PELD) and Unilateral Biportal Endoscopic Discectomy (UBED). The meta-analysis aims to compare the efficacy and procedural efficiency of UBED and PELD.

Methods

PubMed, Cochrane Central, and ScienceDirect were searched till May 2025. Risk ratios (RRs) and mean differences (MDs) were pooled under the random effects model using the Review Manager software version 5.4.1. Quality assessment was performed using the Newcastle-Ottawa Scale. Subgroup analysis was performed based on PELD subtypes: percutaneous transforaminal endoscopic discectomy (PTED) and percutaneous endoscopic interlaminar discectomy (PEID).

Results

Twenty-three studies, pooling 2,271 patients, were included in this meta-analysis. UBED was associated with significantly increased procedural duration (MD = 12.91; 95%CI: [7.71,18.12]; p < 0.00001) and hospitalization (MD = 1.21; 95%CI: [0.44, 1.97]; p = 0.002) though it decreased the LDH recurrence (RR = 0.31; 95%CI: [0.14, 0.68]; p = 0.003) when compared to PELD. PTED was the only technique associated with favourable hospitalization duration and Visual analog scale (VAS) back score as UBED increased these endpoints in the subgroup analysis (MD = 1.54; 95%CI: [0.38, 2.70]; p = 0.009) and (MD = 0.31; 95%CI: [0.08, 0.54]; p = 0.009), respectively. PEID was the only technique associated with favourable ODI scores, as UBED increased this endpoint in subgroup analysis (MD = 1.31; 95% CI: [0.12, 2.49]; p = 0.03). Additionally, PEID demonstrated comparable efficacy to UBED in terms of LDH recurrence (RR = 0.58; 95% CI: [0.20, 1.65]; p = 0.31).

Conclusion

UBED may have longer operative time and hospital stay, but may show fewer LDH recurrences than PELD. PTED may show favourable hospitalization duration and VAS back scores, while PEID may show favourable ODI scores and similar recurrence rates to UBED.