Comparative Efficacy of Unilateral Biportal Endoscopy vs Traditional Surgery in Lumbar Degenerative Disorders.

Abstract

BACKGROUND Lumbar degenerative diseases, such as lumbar disc herniation, cause significant pain and neurological deficits. Traditional surgeries like posteriior lumbar interbody fusion (PLIF) have drawbacks, including extensive tissue damage. We sought to evaluate the efficacy of unilateral biportal endoscopy (UBE) compared with PLIF, with a focus on clinical outcomes and complication rates. MATERIAL AND METHODS This retrospective study (January 2020 to January 2023) included 109 patients with lumbar degenerative diseases; 53 treated with UBE and 56 with PLIF. We followed Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines with ethical approval. The statistical analyses used t-tests and Chi-square tests (P<0.05). RESULTS The UBE group showed significantly shorter surgery times (107.3±11.2 minutes) and less intraoperative blood loss (50.2±5.7 mL) compared with the PLIF group (113.5±15.7 minutes; 91.3±9.0 mL). Postoperative pain reduction was greater in the UBE group, with a mean Visual Analogue Scale (VAS) score of 3.50±0.85 vs 4.10±0.95 in the PLIF group (P<0.001). The UBE group also had better lumbar function recovery, with higher Japanese Orthopaedic Association scores (19.80±2.30 vs 17.20±2.05; P<0.001). The incidence of postoperative complications was lower in the UBE group (5.67%) compared with the PLIF group (14.29%), although this difference was not statistically significant (P=0.14). CONCLUSIONS UBE could offer significant clinical efficacy in treating lumbar degenerative diseases. It may improve surgical outcomes, reduce postoperative pain, and present a favorable safety profile. These findings suggest UBE might be a viable, minimally invasive option, promoting better recovery and fewer complications.