Abstract：Objective This aimed to investigate the clinical effect of percuteneous endoscopic interlaminar discectomy (PEID) and microscopy-assisted discectomy (MSLD) in the treatment of L5/S1 disc herniation. Methods A retrospective cohort study was conducted. A total of 42 patients with simple L5/S1 intervertebral disc herniation who were admitted in the Department of Orthopedics and Spinal Surgery of the First Affiliated Hospital of University of Science and Technology of China from January 2021 to June 2022 were included, including 33 males and 9 females, aged 19-42 years. All 42 patients received minimally invasive spinal surgery, and they were divided into two groups based on the surgical method: 21 patients in the endoscopic group, who were treated with PEID, and 21 patients in the microscopic group, who were treated with MSLD. The baseline data of the two groups were compared, and perioperative indexes, such as incision length, operation time, blood loss, and length of hospital stay, and surgical complications were observed. Neurological function and lower limb pain relief were assessed by using the modified Oswestry Disability Index (ODI) and visual analog scale (VAS) before surgery and 1, 3, and 6 months after surgery, respectively. Intervertebral height changes were assessed by using the disc height index (DHI). Results No significant differences in gender, age, body mass index, and other baseline data were observed between the two groups (all P values >0.05). The incision length and intraoperative blood loss in the endoscopic group were (0.95±0.08) cm and (6.05±1.47) mL, which were smaller than those in the microscopic group ([2.09±0.12] cm and [26.19±5.68] mL, respectively), and the differences were statistically significant (t=-15.74, -35.24, all P values <0.001). No intraoperative or postoperative complications occurred in the two groups. ODI and VAS scores in the endoscopic group and microscopic group were statistically significant before surgery and at 1, 3, and 6 months after surgery (all P values <0.001). No significant difference in DHI was observed between the PEID group and MSLD group at different time points (all P values >0.05). Conclusion PEID and MSLD are safe and effective in the treatment of L5/S1 disc herniation. Compared with MSLD, PEID has a better protective effect on paravertebral muscle, smaller incision, and less blood loss; thus, it is consistent with the concept of minimally invasive.
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Liu Pengfei, Zhang Wenzhi, He Rui, Xu Xiang, Duan Liqun. Effect of percuteneous endoscopy interlaminar discectomy and microscopy-assisted nuclear pulposus extraction in the treatment of L5/S1 disc herniation. Chinese Journal of Anatomy and Clinics, 2023, 28(5): 308-312.
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2023, Vol. 28 
