目的 探讨经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症（LDH）的疗效。方法 选取2021年1月—2023年12月在我院进行经皮椎间孔镜髓核摘除术治疗的140例LDH患者作为微创组,同期选取在我院进行椎板开窗髓核摘除术治疗的140例LDH患者作为对照组,对两组治疗效果进行对比分析。结果 微创组手术时间、术中出血量及术后首次下床时间均显著少于对照组（P<0.05）。两组治疗总有效率比较,差异无统计学意义（P>0.05）;微创组并发症发生率显著低于对照组（P<0.05）。术前两组视觉模拟评分法（VAS）评分、健康调查量表36（SF-36）评分、Oswetry功能障碍指数（ODI）、日本骨科学会（JOA）评分、腰椎前凸角、腰骨倾斜角比较,差异均无统计学意义（P>0.05）;经手术治疗后,两组疼痛情况（VAS评分降低）、腰椎功能（ODI降低、JOA评分增高）、脊柱稳定性（腰椎前凸角度、腰骨倾斜角均增加）及生活质量（SF-36评分增高）均较术前得到显著改善（P<0.05）,其中SF-36评分、腰椎前凸角度、腰骨倾斜角在微创组的改善情况显著优于对照组（均P<0.05）,VAS评分、ODI、JOA评分改善情况在两组间差异无统计学意义（P>0.05）。结论 与椎板开窗髓核摘除术相比,经皮椎间孔镜下髓核摘除术用于治疗LDH在保证治疗效果的同时可显著缩短手术时间、促进术后恢复、提高脊柱稳定性和患者生活质量,同时显著降低术后并发症的发生,值得推广。

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.