Effect and safety of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation: direct inferior endplate approach versus indirect approach.

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY European Spine Journal Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI:10.1007/s00586-025-08667-6
Zhicheng Li, Bo Liu, Liyan Su
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Abstract

Objective: To explore the efficacy and safety of the direct inferior endplate approach in percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of L5-S1 disc herniation.

Methods: This was a retrospective analysis of 116 patients with L5-S1 disc herniation treated with PEID; 74 patients underwent surgery via the direct inferior endplate approach (group A), and 42 patients underwent surgery via the indirect approach (group B). The number of intraoperative fluoroscopy exposures, establishment channel time, operation time, postoperative visual analogue scale (VAS) score, and Oswestry Disability Index (ODI) were compared between the 2 groups.

Results: Compared with those in Group B, the channel establishment time, number of fluoroscopy exposures, and operation time in Group A were significantly lower (P < 0.05). There was no significant difference in the VAS score or ODI between the two groups (P > 0.05).

Conclusions: Compared with the indirect approach, the direct inferior endplate approach can allow the exposed target to be reached more quickly, shorten the operation time, and reduce the degree of radiation exposure of doctors and patients, resulting in a high safety profile.

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经皮内窥镜椎间盘切除术治疗L5-S1椎间盘突出症的疗效和安全性:直接下终板入路与间接入路。
目的:探讨经皮内窥镜椎间盘切除术(PEID)中直接下终板入路治疗L5-S1椎间盘突出症的疗效和安全性。方法:回顾性分析116例使用PEID治疗的L5-S1椎间盘突出症患者;采用直接下终板入路74例(A组),采用间接入路42例(B组)。比较两组患者术中透视照射次数、建立通道时间、手术时间、术后视觉模拟评分(VAS)评分、Oswestry残疾指数(ODI)。结果:与B组比较,A组的通道建立时间、透视次数、手术时间均显著低于B组(P < 0.05)。结论:与间接入路相比,直接下终板入路能更快到达照射目标,缩短手术时间,降低医患辐射暴露程度,安全性高。
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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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