J Minim Invasive Spine Surg Tech.  2025 Apr;10(1):60-68. 10.21182/jmisst.2024.01529.

Clinical Comparison of the Unilateral Biportal Endoscopic Technique Versus Microendoscopic Discectomy for Single-Level Lumbar Discectomy: A Retrospective Analysis

• Delat R
• Prajapati D
• Rao N
• Patel A
• Shaikh S

• KMID: 2567497
• DOI: http://doi.org/10.21182/jmisst.2024.01529

Abstract

Objective
The unilateral biportal endoscopic (UBE) technique represents the most recent minimally invasive approach to spinal surgery, while microendoscopic discectomy (MED) is a commonly employed surgical intervention. The UBE approach utilizes conventional arthroscopic systems. This study conducted a retrospective analysis of perioperative parameters and clinical outcomes following UBE and MED for the treatment of herniated discs.
Methods
This is a retrospective review of data from 65 patients who underwent discectomy for symptomatic herniated nucleus pulposus. These patients were treated between July 2022 and October 2022 with a follow-up of 6 months. Among them, 33 patients underwent the UBE technique, while 32 patients underwent MED. The length of operation time, hospital stays, and time to return to work were compared. Visual analogue scale (VAS) score, the Oswestry Disability Index (ODI), the MacNab score, and complications were evaluated.
Results
Five patients were lost to follow-up, leaving 30 patients in each group. Significant improvements were observed in the mean VAS scores for back and leg pain, MacNab scores, and ODI scores in both the UBE and MED groups (p<0.05). At the 1-week postoperative assessment, the UBE group exhibited a significantly greater improvement in back and leg VAS scores. Regarding perioperative parameters, the UBE group had a longer operative time. No statistically significant differences were observed in terms of surgical complications and time to return to work.
Conclusion
In this study, UBE for single-level discectomy demonstrated comparable clinical outcomes to MED in terms of pain management, functional disability, and patient satisfaction at 6 months. However, UBE showed advantages in terms of better intraoperative visualization, which contributed to fewer complications and less early postoperative back pain.

Keyword

Minimally invasive spine surgery; Unilateral biportal endoscopy; Endoscopic surgery; Lumbar disc herniation; Spine surgery