经皮椎间孔镜与单侧双通道内镜治疗腰椎间盘突出症的临床疗效比较

Objective To comprehensively compare the clinical efficacy and perioperative characteristics of percutaneous transforaminal endoscopic discectomy(PTED) versus unilateral biportal endoscopic discectomy(UBE) in treating lumbar disc herniation. Methods The data of 70 cases of lumbar disc protrusion were statistically analyzed. According to the actual surgical methods, they were divided into the PTED group with 35 cases and the UBE group with 35 cases. The visual analog scale(VAS) scores and oswestry disability index(ODI) were compared between the two groups before surgery and at 1 day, 1 month, and 3 months postoperatively. Intraoperative blood loss, number of fluoroscopic procedures, operative time, hospital stay, and modified MacNab satisfaction rate were also analyzed. Group mean differences and 95%CI were calculated using means, standard deviations, and sample sizes. Results Both groups showed significant reductions in VAS and ODI scores postoperatively compared to preoperative levels(P<0.05), with no statistically significant differences observed at any follow-up time point(P>0.05). The PTED group had a lower intraoperative blood loss(9.76 mL) and shorter operative time(24.88 min) than the UBE group. The UBE group required 3.56 fewer fluoroscopic procedures, both differences being statistically significant(P<0.001). No statistically significant differences were observed in hospital stay or MacNab satisfaction rates between the two groups(P>0.05). Conclusion Both PTED and UBE are effective in alleviating pain and improving lumbar function in patients with lumbar disc herniation. PTED offers superior advantages in reducing bleeding and shortening operative time, whereas UBE minimizes intraoperative fluoroscopy requirements and facilitates extensive bone decompression. The choice of technique should be based on the type of protrusion, degree of stenosis, anatomical conditions, and surgeon experience.