Clinical Comparison of Percutaneous Endoscopic Transforaminal Discectomy with Foraminoplasty and Unilateral Biportal Endoscopic Discectomy for Lumbar Disc Herniation: A Retrospective Study

Objective: To compare the clinical outcomes and respective advantages of percutaneous endoscopic transforaminal discectomy with foraminoplasty (PETD) and unilateral biportal endoscopic discectomy (UBED) in patients with lumbar disc herniation (LDH). Methods: A retrospective analysis was conducted on patients who underwent UBED (n=90) or PETD (n=65) at Xi’an Honghui Hospital from October 2022 to October 2023. The demographic and perioperative variables included sex, age, BMI, disease course, surgical time, intraoperative blood loss, hospitalization duration, postoperative hospitalization duration, number of fluoroscopies, incision length, and follow-up period. Clinical outcomes were assessed via lumbar/leg visual analog scale (VAS) scores and the Oswestry Disability Index (ODI). Radiographic assessment before and after surgery focused on intervertebral disc height changes. Complications (incision infections, nerve root injuries, cerebrospinal fluid leaks, postoperative headaches) and recurrence rates within 6 months were recorded. Results: Both techniques significantly improved the VAS and ODI scores postoperatively, with no intergroup differences. The UBED group had longer operative times (98.93±38.24 vs. 82.89±46.06 mins, P=0.019) and greater blood loss (76.89±66.29 vs. 47.23±45.89 mL, P=0.002). PETD was associated with shorter incisions (0.85±0.18 vs. 1.78±0.21 cm, P