Li Zhicheng, Liu Bo, Su Liyan
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.
Eur Spine J. 2025 Mar;34(3):1115-1122. doi: 10.1007/s00586-025-08667-6. Epub 2025 Jan 27.
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.
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.
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).
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.
探讨直接下终板入路在经皮内镜椎间孔镜下腰椎间盘切除术（PEID）治疗L5-S1椎间盘突出症中的疗效及安全性。
回顾性分析116例行PEID治疗的L5-S1椎间盘突出症患者；74例患者采用直接下终板入路手术（A组），42例患者采用间接入路手术（B组）。比较两组患者术中透视次数、建立通道时间、手术时间、术后视觉模拟评分（VAS）及Oswestry功能障碍指数（ODI）。
与B组相比，A组建立通道时间、透视次数及手术时间明显更低（P < 0.05）。两组患者VAS评分及ODI差异无统计学意义（P > 0.05）。
与间接入路相比，直接下终板入路能更快到达暴露靶点，缩短手术时间，降低医患辐射暴露程度，安全性高。
