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Objective <p>Systematically compare the efficacy and safety of unilateral biportal endoscopy(UBE) and percutaneous endoscopic foraminal discectomy(PETD) in the treatment of lumbar disc herniation (LDH).</p> Methods <p>Search PubMed, Cochrane Library, Web of Science, Embase, CNKI and other Chinese and English databases to screen clinical controlled studies published as of August 2025. Included studies need to report indicators such as excellent and good surgical rate, operation time, blood loss, fluoroscopy times, hospital stay, visual analog score (VAS), Oswestry dysfunction index (ODI), and complications. Meta analysis was performed using RevMan 5.3, with odds ratios (OR) used for binary variables, and mean differences (MD) and 95% confidence intervals (CI) used for continuous variables.</p> Results <p>A total of 12 studies involving 1,089 patients (536 in UBE group and 553 in PETD group) were included. The results showed no significant differences between the groups in surgical outcomes, operative quality rate (OR = 1.06,95% CI: 0.66–1.71, <i>P</i> = 0.81), ODI scores (MD=-0.28,95% CI: -0.73–0.18, <i>P</i> = 0.23), or complication rates (OR = 0.70,95% CI: 0.37–1.35, <i>P</i> = 0.29). PETD group demonstrated superiority in operative time (MD = 12.69&#xa0;min, <i>P</i> = 0.002), intraoperative blood loss (MD = 28.35 mL, <i>P</i> = 0.0002), incision length (MD = 1.04&#xa0;cm, <i>P</i> &lt; 0.00001), and hospitalization duration (MD = 0.85 days, <i>P</i> = 0.008). Conversely, the UBE group demonstrated a statistically significant but clinically minimal advantage in postoperative VAS scores for low back pain (MD = -0.08, <i>P</i> = 0.0005) and leg pain (MD = -0.10, <i>P</i> = 0.002), with both differences falling well below established MCID thresholds for VAS in spine populations. In contrast, UBE achieved a clinically meaningful advantage over PETD in reducing intraoperative fluoroscopy times (MD = -3.86, <i>P</i> &lt; 0.00001).</p> Conclusion <p>The overall efficacy and safety of UBE and PETD in the treatment of LDH are comparable. PETD demonstrates advantages in surgical efficiency, reduced invasiveness, and faster recovery. UBE achieves a clinically meaningful advantage in reducing intraoperative fluoroscopy exposure; however, its statistically lower postoperative VAS scores for back and leg pain fall below established MCID thresholds and are not clinically relevant. Therefore, neither technique should be considered superior to the other in terms of postoperative pain relief in clinical practice.</p>

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Efficacy and safety of unilateral biportal endoscopy versus Percutaneous endoscopic foraminal discectomy in the treatment of lumbar disc herniation: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年5月28日

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  • Alimujiang Yusufu,
  • Parhat Yasin,
  • Abudula Abulaiti,
  • Yuan Ma

摘要

Objective

Systematically compare the efficacy and safety of unilateral biportal endoscopy(UBE) and percutaneous endoscopic foraminal discectomy(PETD) in the treatment of lumbar disc herniation (LDH).

Methods

Search PubMed, Cochrane Library, Web of Science, Embase, CNKI and other Chinese and English databases to screen clinical controlled studies published as of August 2025. Included studies need to report indicators such as excellent and good surgical rate, operation time, blood loss, fluoroscopy times, hospital stay, visual analog score (VAS), Oswestry dysfunction index (ODI), and complications. Meta analysis was performed using RevMan 5.3, with odds ratios (OR) used for binary variables, and mean differences (MD) and 95% confidence intervals (CI) used for continuous variables.

Results

A total of 12 studies involving 1,089 patients (536 in UBE group and 553 in PETD group) were included. The results showed no significant differences between the groups in surgical outcomes, operative quality rate (OR = 1.06,95% CI: 0.66–1.71, P = 0.81), ODI scores (MD=-0.28,95% CI: -0.73–0.18, P = 0.23), or complication rates (OR = 0.70,95% CI: 0.37–1.35, P = 0.29). PETD group demonstrated superiority in operative time (MD = 12.69 min, P = 0.002), intraoperative blood loss (MD = 28.35 mL, P = 0.0002), incision length (MD = 1.04 cm, P < 0.00001), and hospitalization duration (MD = 0.85 days, P = 0.008). Conversely, the UBE group demonstrated a statistically significant but clinically minimal advantage in postoperative VAS scores for low back pain (MD = -0.08, P = 0.0005) and leg pain (MD = -0.10, P = 0.002), with both differences falling well below established MCID thresholds for VAS in spine populations. In contrast, UBE achieved a clinically meaningful advantage over PETD in reducing intraoperative fluoroscopy times (MD = -3.86, P < 0.00001).

Conclusion

The overall efficacy and safety of UBE and PETD in the treatment of LDH are comparable. PETD demonstrates advantages in surgical efficiency, reduced invasiveness, and faster recovery. UBE achieves a clinically meaningful advantage in reducing intraoperative fluoroscopy exposure; however, its statistically lower postoperative VAS scores for back and leg pain fall below established MCID thresholds and are not clinically relevant. Therefore, neither technique should be considered superior to the other in terms of postoperative pain relief in clinical practice.