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Delta large-channel endoscopy versus unilateral biportal endoscopy for cervicothoracic junction disc herniation: a
Huaibin Wang1,2, Hui Li3, Rushuo Wei1,2
1Department of Spinal Surgery, Weifang People's Hospital, Shandong Second Medical University, 151 Guangwen Street, Kuiwen District, Weifang, 261000, Shandong, China.
Journal of Orthopaedic Surgery and Research
|January 15, 2026
Summary
The Delta large-channel endoscopic approach for cervicothoracic junction disc herniation (CTJDH) showed less blood loss and quicker recovery than unilateral biportal endoscopy (UBE). However, UBE may be better for patients with osteophytes.
Area of Science:
- Minimally Invasive Spine Surgery
- Cervicothoracic Junction Disorders
- Endoscopic Spinal Decompression
Background:
- Anterior surgical approaches for cervicothoracic junction disc herniation (CTJDH) are challenging due to anatomical obscuration.
- Posterior decompression techniques, including Delta large-channel endoscopy and unilateral biportal endoscopy (UBE), offer promising alternatives.
- This study prospectively compares the clinical outcomes of Delta and UBE endoscopic surgeries for CTJDH.
Purpose of the Study:
- To compare the clinical efficacy and safety of Delta large-channel endoscopy versus unilateral biportal endoscopy (UBE) for treating CTJDH.
- To evaluate differences in patient outcomes, including functional recovery, pain reduction, and surgical parameters.
Main Methods:
- A prospective randomized controlled study involving 63 patients with CTJDH, assigned to either the Delta (n=32) or UBE (n=31) group.
- Primary outcome measures included the Neck Disability Index (NDI) and intraoperative blood loss (IBL).
- Secondary outcomes assessed included VAS pain scores, JOA scores, operative time, hospital stay, complications, and radiographic parameters.
Main Results:
- The Delta group demonstrated significantly lower NDI scores at postoperative day 14 and one month compared to the UBE group.
- Intraoperative blood loss was significantly lower in the Delta group (p < 0.001), and postoperative VAS scores were also lower at multiple time points.
- The UBE group had a shorter operative time (p < 0.001), while both techniques improved radiographic parameters (Cobb angle, cSVA). Delta group patients with osteophytes showed poorer NDI scores.
Conclusions:
- Both Delta and UBE endoscopic approaches are safe and effective for CTJDH treatment.
- The Delta technique offers advantages in reduced blood loss and faster initial recovery but has a longer operative time.
- UBE may provide comparable outcomes for CTJDH with osteophytes, suggesting individualized treatment selection based on patient anatomy.
