Abstract: Objective  To compare the clinical efficacy between unilateral biportal endoscopy (UBE) and percutaneous endoscopic lumbar discectomy (PELD) in the treatment of patients with lumbar disc herniation (LDH). Methods  A total of 87 cases of LDH treated with spinal endoscopy from March 2020 to March 2022 were analyzed retrospectively, including 39 cases by UBE and 48 cases by PELD. The relevant data of the two groups of patients were recorded separately, including age, gender, body mass index (BMI), hospital stay, surgical time, intraoperative X-ray times, bleeding volume, preoperative and postoperative hemoglobin (Hb) reduction, follow-up time, postoperative complications. The Visual Analogue Scale (VAS) for low back pain and leg pain respectively, and Oswestry Disability Index (ODI) were evaluated before surgery, 1 month, 3 months and 12 months after operation. The modified MacNab criteria were used for evaluation of the clinical outcomes at 12 months after operation. The changes of dural sac area between two groups of patients before surgery and 12 months after surgery were compared. Results  All patients successfully completed the surgery. There was no statistically significant difference in age, gender, BMI, hospital stay, surgical time, follow-up time, and postoperative complications between the two groups of patients (P>0.05). UBE group had more intraoperative bleeding compared to PELD group (P<0.05), but there was no statistically significant difference in Hb reduction (P>0.05). The times of intraoperative X-ray in the UBE group was lower than that in the PELD group (P<0.05). The VAS score of low back and leg pain and ODI in the two groups of patients at 1 month, 3 months, and 12 months after surgery were significantly reduced compared to that before surgery (P<0.05). There was no statistical difference in VAS score of low back and leg pain and ODI at each time point between the two groups of patients (P>0.05). There was no statistically significant difference in the excellent and good rate of modified MacNab criteria between the two groups after surgery (P>0.05). The dural sac area of both groups significantly increased at 12 months after surgery compared to that  before (P<0.05), and the area of UBE group was more bigger than that of PELD group (P<0.05). Conclusion  UBE and PELD can effectively relieve pain and improve the quality of life of patients with LDH. UBE has slightly more bleeding volume than PELD, but has fewer intraoperative X-ray times and a bigger increase in dural sac area.

Key words: unilateral biportal endoscopy, percutaneous endoscopic lumbar discectomy, lumbar disc herniation, clinical efficacy