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

作者信息

Li Zhicheng, Liu Bo, Su Liyan

机构信息

Department of Pain, Dongguan Binhaiwan Central Hospital, Dongguan City, Guangdong Province, 523905, China.

Department of Traditional Chinese Medicine, Dongguan Binhaiwan Central Hospital, Dongguan City, Guangdong Province, 523905, China.

出版信息

Eur Spine J. 2025 Mar;34(3):1115-1122. doi: 10.1007/s00586-025-08667-6. Epub 2025 Jan 27.

DOI:10.1007/s00586-025-08667-6

PMID:39870983

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.

摘要