Comparison of Unilateral Biportal Endoscopic Discectomy and Microdiscectomy for Lumbar Disc Herniation: A Single-Center 1-Year Experience

Objective: The aim of this study was to compare the clinical, functional, and safety outcomes of unilateral biportal endoscopic (UBE) discectomy and lumbar microdiscectomy (LMD) in the surgical treatment of lumbar disc herniation. Methods: This single-center, retrospective study included a total of 87 patients who underwent surgery for lumbar disc herniation. Patients were divided into two groups according to the surgical technique: LMD (n=40) and UBE (n=47). Clinical outcomes were assessed using preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, the Oswestry Disability Index (ODI), and the modified MacNab criteria at postoperative 3 months. Operative time and intraoperative and postoperative complications were also recorded. Results: There were no significant differences between the groups in terms of preoperative VAS-back, VAS-leg, or ODI scores. The UBE group demonstrated significantly lower VAS-back scores in the early and mid-term postoperative periods compared with the LMD group (p<0.001). No significant differences were observed between the groups in postoperative 8 hours VAS-leg scores, ODI scores, or MacNab outcomes. Operative time was significantly longer in the UBE group (p<0.001). A limited number of complications, including recurrent disc herniation, dural tears, and epidural hematoma, were observed in the UBE group, while no permanent neurological deficits occurred in either group. Conclusion: UBE is a safe and effective surgical alternative that provides advantages in early pain control while achieving functional outcomes and patient satisfaction comparable to those of microdiscectomy. The choice of surgical technique should be individualized based on patient characteristics and surgeon experience.