Unilateral biportal endoscopic decompression Proves Safe and Effective for Managing FLLDH: Study
A new study published in the journal of BMC Surgery revealed that far lateral lumbar disc herniation (FLLDH) presents diagnostic and surgical challenges, but unilateral biportal endoscopic decompression (UBED) offers outcomes comparable to conventional LDH treatments, which ensures safety, effective pain relief, minimal complications, and favorable long-term surgical results.
This study from April 2023 to January 2024, analyzed 25 patients who underwent UBED for single-level FLLDH and compared their outcomes with 30 patients treated for the more common paracentral lumbar disc herniation (LDH).
This research reported that patients in the FLLDH group underwent a significant reduction in pain and disability after surgery. The Visual Analogue Scale (VAS) scores for both back pain (VAS-BP) and leg pain (VAS-LP), as well as the Oswestry Disability Index (ODI), showed marked improvement when compared to preoperative levels.
Before surgery, the patients with FLLDH reported higher leg pain scores than the individuals with paracentral LDH, which indicated a more severe initial symptom burden. However, postoperatively, both groups showed similar pain relief and functional recovery, suggesting that UBED is equally effective across different disc herniation types.
The mean operative time for the UBED procedure was approximately 96 minutes, and the average hospital stay was 6.44 days, both reflecting efficient surgical management for a complex spinal condition. Drainage volume and postoperative hospitalization durations were within acceptable clinical ranges.
The complications were minimal and statistically similar between the groups. There were no reports of significant nerve injury, infection, or recurrent herniation. Also, no notable progression in disc or adjacent segment degeneration was observed during the follow-up period.
Based on the modified MacNab criteria, which assessed postoperative functional outcomes and patient satisfaction, 88% of the FLLDH patients achieved “good” to “excellent” results. These high satisfaction rates highlight UBED’s potential as a preferred option for treating far lateral disc herniations cases that have traditionally been more difficult to manage due to their anatomical complexity. Overall, the findings of this study suggests that UBED is a viable and effective surgical method for FLLDH, offering pain relief, functional improvement, and low complication rates comparable to more common LDH surgeries.
Source:
Yuan, S., Ma, Z., Chen, R., Wang, A., Xi, Y., Wang, T., Fan, N., Du, P., & Zang, L. (2025). Clinical outcomes of unilateral biportal endoscopic discectomy for the treatment of far lateral lumbar disc herniation: a retrospective comparative study. BMC Surgery, 25(1), 457. https://doi.org/10.1186/s12893-025-03210-2
