Related Experiment Video
Updated: Aug 19, 2026
The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
Unilateral Biportal Endoscopic Diskectomy Versus Percutaneous Endoscopic Lumbar Diskectomy for Lumbar Disk
Chen Wang1, Weiyi Lin2, Fenglang Li3
1Department of Orthopaedics, West China Hospital, West China Xiamen Hospital, Sichuan University, Xiamen, Fujian, China
Background:
This meta-analysis compared the clinical efficacy of unilateral biportal endoscopic diskectomy (UBE) and percutaneous endoscopic lumbar diskectomy (PELD) for lumbar disk herniation.
Materials And Methods:
A systematic search of PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Wanfang was conducted from inception to May 2025. Comparative studies in adults undergoing UBE or PELD were included. Outcomes included operative and recovery parameters, complications, reoperation, Macnab outcomes, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), fluoroscopy exposure, and total cost. Pooled effects were calculated as mean differences or odds ratios with 95% confidence intervals. Prespecified subgroup analyses (PELD approach and operative level) and sensitivity analyses (leave-one-out/model switching) were performed. Clinical relevance was interpreted using commonly cited minimal clinically important difference thresholds for VAS and ODI.
Results:
A total of 25 studies involving 2,087 patients were included. Compared with PELD, UBE was associated with longer operative time, greater intraoperative blood loss, larger incisions, longer hospital stays, and higher hospitalization costs, but significantly fewer intraoperative fluoroscopy exposures. No significant differences were observed in complication or reoperation rates. Although some statistically significant differences were detected in early perioperative metrics, all between-group differences in VAS pain and ODI functional scores were far below the minimal clinically important difference thresholds, confirming clinically equivalent mid-term outcomes. Subgroup analyses identified that PELD approach and operative level were key contributors to between-study heterogeneity, and sensitivity analyses confirmed that our main conclusions remained stable.
Conclusion:
Both UBE and PELD are safe and effective minimally invasive strategies for lumbar disk herniation, with comparable clinical efficacy. PELD offers advantages in lower surgical trauma and cost effectiveness, whereas UBE reduces intraoperative radiation exposure. Surgical selection should be individualized based on patient pathology and surgeon expertise.
