关键词: 腰椎间盘突出症, 椎板开窗髓核摘除术, 经皮椎间孔镜髓核摘除术, 腰椎功能, 脊柱稳定性

Abstract: Objective To investigate the effect of percutaneous intervertebral foraminoscopic extraction of nucleus pulposus on lumbar disc herniation （LDH）. Methods In this study, 140 LDH patients who underwent percutaneous intervertebral foraminoscopic nucleus pulpotomy in our hospital from January 2021 to December 2023 were selected as the minimally invasive group, and 140 LDH patients who underwent laminary-fenestration nucleus pulpotomy in our hospital at the same time period were selected as the control group, and the therapeutic effects of the two groups were compared and analyzed. Results The operative time, intraoperative blood loss, and the first time to get out of bed in the minimally invasive group were significantly less than those in the control group （P<0.05）. There was no significant difference in the total effective rate between the two groups （P>0.05）. The complication rate of the minimally invasive group was significantly lower than that of the control group （P<0.05）. Before surgery, the visual analog scale （VAS） scores, 36-time short-form survey （SF-36） scores, Oswestry disability index （ODI）, Japanese Orthopaedic Association （JOA） scores, lumbar lordosis angle, and lumbar bone inclination angle were not significantly different between the two groups （P>0.05）. After surgery, the pain level （VAS score reduced）, lumbar spine function （ODI reduced, and JOA score increased）, spinal stability （lumbar lordosis angle and lumbar bone inclination angle both increased）, and quality of life （SF-36 score increased） were significantly improved in the two groups compared with before surgery （P<0.05）. Postoperative SF-36 score, lumbar lordosis angle, and lumbar bone inclination angle in the minimally invasive group were significantly better than those in the control group （P<0.05）, but there was no significant difference in VAS, ODI, and JOA scores between the two groups （P>0.05）. Conclusion Compared with fenestration of laminae, percutaneous foraminoscopic extraction of nucleus pulposus for the treatment of LDH can significantly shorten operation time, promote postoperative recovery, improve spinal stability and patients' quality of life, and significantly reduce the occurrence of postoperative complications, so it can be popularized.

Key words: Lumbar disc herniation, Fenestration of laminae nucleus pulposus, Percutaneous foraminoscopic extraction of nucleus pulposus, Lumbar spine function, Spinal stability