Clinical Efficacy of Biportal versus Uniportal Endoscopic Discectomy for Far Lateral Lumbar Disc Herniation: A Retrospective Study Analysis.

Abstract

This study aimed to compare the clinical efficacy and safety of percutaneous transforaminal endoscopic discectomy (PTED) and unilateral biportal endoscopy (UBE) in treating far lateral lumbar disc herniation (FLLDH). A retrospective analysis was performed on 42 patients treated for FLLDH at our hospital between January 2020 and October 2023, comprising 17 UBE cases and 25 PTED cases. Patients were followed up for six months. The study compared operation time, hospital stay, cross-sectional area of the intervertebral foramen, and clinical efficacy using a visual analog scale (VAS), the Oswestry Disability Index, and modified Macnab criteria. Both surgical procedures were successful. The UBE group had a significantly shorter operation time than the PTED group (108.0 ± 35.3 vs. 84.3 ± 25.4 minutes; P = 0.023). There were no significant differences in hospitalization periods or cross-sectional area of the intervertebral foramen between the groups. The UBE group had better VAS scores for back pain at 1-day (2.72 ± 0.84 vs. 2.12 ± 0.70, P = 0.015) and 1-month (1.76 ± 0.66 vs. 1.29 ± 0.77, P = 0.047) postoperation compared to the PTED group. However, both groups showed significant improvements in VAS and Oswestry Disability Index scores after surgery, with no statistically significant difference at the final follow-up. The modified Macnab criteria at the final follow-up demonstrated similar good-to-excellent satisfactory outcomes in both the PTED and UBE groups, at 92% and 94.1%, respectively. Both UBE and PTED techniques are clinically effective for treating FLLDH, with UBE having a shorter operation time than PTED.