REVIEW article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicEndoscopy, Navigation, Robotics, Current Trends and Newer Technologies in the Management of Spinal Disorders. Towards a Paradigm Change in the Clinical Practice.View all 20 articles
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
Provisionally accepted
- 1Sixth Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
- 2Xinjiang Medical University, Urumqi, China
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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, UBE group showed significant advantages over PETD group in postoperative low back and leg pain VAS scores (low back VAS: MD= -0.08, P=0.0005; leg VAS: MD= -0.10, P=0.002) and fluoroscopy times during surgery (MD=-3.86, P<0.00001). Conclusion The overall efficacy and safety of UBE and PETD in the treatment of LDH are comparable. PETD has advantages in surgical efficiency, trauma severity and recovery speed, while UBE performs better in postoperative pain control and reducing intraoperative radiation exposure. The selection of clinical surgical methods should be based on the patient's individual conditions and the operator's experience.
Keywords: Lumbar disc herniation, meta analysis, Percutaneousendoscopic foraminal discectomy, Spinal endoscopy, surgical efficacy, Unilateral biportal endoscopy
Received: 30 Sep 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Yusufu, Yasin, Han and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Alimujiang Yusufu
Yuan Ma
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