Unilateral Biportal Endoscopic Discectomy (UBE) Versus Percutaneous Endoscopic Lumbar Discectomy (PELD) for Treating Lumbar Disc Herniation in Obese Patients: A Retrospective Study.

BACKGROUND The prevalence of lumbar disc herniation (LDH) among obese patients is rising annually. Minimally invasive procedures such as unilateral biportal endoscopic discectomy (UBE) and percutaneous endoscopic lumbar discectomy (PELD) have been used with great effectiveness in treating obese individuals with LDH, but no studies have evaluated the clinical results of obese individuals receiving UBE and PELD. MATERIAL AND METHODS We enrolled 43 patients who met specified inclusion criteria to receive UBE (14 patients) and PELD (29 patients). Perioperative assessment parameters included mean operative time, hemoglobin (Hb) loss, length of stay (LOS), drainage volume, and postoperative complications. Assessments were conducted at admission and at 1 month, 3 months, and final follow-up using the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. RESULTS Postoperative assessment revealed marked reductions in both VAS and ODI scores across the 2 treatment groups. No significant differences were found in VAS or ODI scores between the groups before surgery, or at 1 month, 3 months, and final follow-up. In contrast to the PELD group, the UBE group had higher Hb loss, longer operative time, and greater postoperative drainage volume. However, the complication rates were similar, with 4 patients in the PELD group experiencing relapse and 2 with infections, while the UBE group had 1 relapse and 2 cases of dural tears. CONCLUSIONS In obese patients with LDH, UBE and PELD yield similar clinical outcomes. Compared to PELD, UBE resulted in fewer complications and a lower recurrence rate in the short term.