Comparing Unilateral Biportal Endoscopic Discectomy Versus Microdiscectomy for Lumbar Disc Herniation: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Study Design This study is a meta-analysis of randomized controlled trials (RCTs) and observational studies. Objective Lumbar disc herniation (LDH) often requires surgery, with microdiscectomy (MD) being common. This study compares Unilateral Biportal Endoscopic Discectomy (UBED) to conventional and tubular MD for LDH treatment. Methods PubMed, Cochrane Central, and ScienceDirect were searched up to May 2025. Mean differences (MDs) and risk ratios (RRs) were pooled with a random effects model using Review Manager. Quality was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa Scale. Publication bias was evaluated with funnel plots and Egger’s regression test. Results Thirteen studies (11 observational studies and 2 RCTs), pooling 1369 patients, were included. UBED was associated with decreased 1-3 days post-operative (MD: −0.81; 95% CI: [−1.48, −0.14]; P = 0.02) and 12 months post-operative (MD: −0.37; 95% CI: [−0.74, −0.01]; P = 0.04) VAS back pain scores, 12 months post-operative ODI scores (MD: −1.32; 95% CI: [−2.44, −0.19]; P = 0.02), estimated blood loss (MD: −74.42; 95% CI: [−114.11, −34.73]; P = 0.0002), and hospital stay (MD: −1.81; 95% CI: [−2.99, −0.63]; P = 0.003) compared to conventional MD although the operative time was high (MD: 9.07; 95% CI: [1.66, 16.48]; P = 0.02). Concurrently, the 12 months post-operative VAS back pain score (MD: −0.42; 95% CI: [−1.40, 0.56]; P = 0.40) and ODI score (MD: 1.39; 95% CI: [−2.80, 5.58]; P = 0.52) along with the operative time (MD: 21.80; 95% CI: [−26.31, 69.92]; P = 0.37) and hospital stay (MD: 0.02; 95% CI: [−0.30, 0.33]; P = 0.92) were comparable between the UBED and tubular MD. The VAS leg pain scores were comparable between UBED and both conventional and tubular MD. Conclusion UBED may be associated with reduced early and long-term back pain, disability, blood loss, and hospital stays compared to conventional MD, but has longer surgery times, with comparable outcomes to tubular MD. More large-scale RCTs are required to validate these results.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.028 | 0.043 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".