ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
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.
Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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4 authors.
Funding
Abstract
objectiveSystematically compare the efficacy and safety of unilateral biportal endoscopy(UBE) and percutaneous endoscopic foraminal discectomy(PETD) in the treatment of lumbar disc herniation (LDH).
methodsSearch 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.
resultsA 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, the UBE group demonstrated a statistically significant but clinically minimal advantage in postoperative VAS scores for low back pain (MD = -0.08, P = 0.0005) and leg pain (MD = -0.10, P = 0.002), with both differences falling well below established MCID thresholds for VAS in spine populations. In contrast, UBE achieved a clinically meaningful advantage over PETD in reducing intraoperative fluoroscopy times (MD = -3.86, P < 0.00001).
conclusionThe overall efficacy and safety of UBE and PETD in the treatment of LDH are comparable. PETD demonstrates advantages in surgical efficiency, reduced invasiveness, and faster recovery. UBE achieves a clinically meaningful advantage in reducing intraoperative fluoroscopy exposure; however, its statistically lower postoperative VAS scores for back and leg pain fall below established MCID thresholds and are not clinically relevant. Therefore, neither technique should be considered superior to the other in terms of postoperative pain relief in clinical practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.