A Study of Unilateral Biportal Endoscopic Discectomy and Transforaminal Endoscopic Discectomy for Single-level Calcified Lumbar Disc Herniation

Calcified lumbar disc herniation (CLDH) presents unique surgical challenges due to its hard texture and frequent adhesion to neural structures. This study compares the efficacy and safety of unilateral biportal endoscopic discectomy (UBE) and percutaneous endoscopic transforaminal discectomy (PETD) in treating single-level CLDH. An analysis was conducted on 107 patients, with 45 undergoing UBE and 62 PETD. Both techniques significantly improved postoperative visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores. PETD demonstrated advantages in operative time, blood loss, incision length, and hospital stay, but required more intraoperative fluoroscopy. UBE was associated with higher early postoperative low back pain VAS scores and a higher incidence of dural tears (2 cases), whereas PETD resulted in one case of transient nerve root symptoms. While both methods effectively decompress neural elements, PETD offers less invasiveness and faster recovery, particularly beneficial for continuous central calcifications, though it demands specialized instruments and greater radiation exposure. UBE provides a broader operative field and familiar instrumentation but involves more tissue dissection. The findings support the use of either technique for CLDH, with selection influenced by lesion characteristics, surgical expertise, and resource availability. Future efforts should focus on standardizing training and indications to expand access to these minimally invasive options, especially in settings where traditional open surgery remains prevalent.