目的 对比分析后路经皮椎间孔镜椎间盘切除术（PTED）与传统后路腰椎板开窗减压术治疗腰椎间盘突出症的临床疗效。方法 选取2022年1月—2024年1月收治的腰椎间盘突出症患者90例,采用随机数字表法分为对照组和观察组,每组45例。对照组行传统后路腰椎板开窗减压+髓核摘除术,观察组行PTED+髓核摘除术。比较两组患者手术指标（手术时间、术后首次下床时间、切口长度、术中出血量）、腰椎功能恢复情况[Oswestry功能障碍指数（ODI）、日本骨科协会（JOA）评分、视觉模拟评分法（VAS）评分]、血清学指标[C反应蛋白（CRP）、白细胞介素1β（IL-1β）、基质金属蛋白酶3（MMP-3）]及并发症发生率。结果 观察组手术时间和术后首次下床时间均短于对照组,切口长度和术中出血量均少于对照组,差异有统计学意义（均P<0.05）。术前两组ODI、JOA、VAS评分差异无统计学意义（P>0.05）;术后6个月,观察组ODI评分低于对照组（改善率达90%以上）,JOA评分高于对照组,VAS评分低于对照组（均P<0.05）。术前两组血清CRP、IL-1β、MMP-3水平差异无统计学意义（P>0.05）;术后观察组上述指标均低于对照组（P<0.05）。观察组并发症总发生率为6.67%,低于对照组的22.22%（P<0.05）。结论 PTED联合髓核摘除术治疗腰椎间盘突出症临床疗效更优,能缩短手术及康复时间,改善腰椎功能,降低炎症反应和并发症发生率,值得临床推广。

Objective To compare the efficacy of percutaneous transforaminal endoscopic discectomy （PTED） versus traditional posterior laminotomy decompression in the treatment of lumbar disc herniation. Methods A total of 90 patients with lumbar disc herniation admitted to our hospital between January 2022 and January 2024 were selected and randomly divided into a control group and an observation group by random number table method. The control group （45 cases） underwent traditional posterior laminotomy decompression combined with nucleotomy, while the observation group （45 cases） received PTED combined with nucleotomy. The following parameters were compared between the two groups： surgical parameters （operation time, time of first postoperative ambulation, incision length, and intraoperative blood loss）, lumbar spine functional recovery [Oswestry Disability Index （ODI）, Japanese Orthopaedic Association （JOA） score, and Visual analog scale （VAS） score], serum markers [C-reactive protein （CRP）, interleukin-1β （IL-1β）, and matrix metalloproteinase-3 （MMP-3）], and complication rates. Results The observation group exhibited shorter operation time and first postoperative ambulation time compared to the control group, as well as lower intraoperative incision length and less blood loss （P<0.05）. No statistically significant differences in ODI, JOA, and VAS scores were observed between the groups before treatment （P>0.05）; 6 months after operation, compared to the control group, the observation group had lower ODI scores （with an improvement rate of over 90%）, higher JOA scores, and lower VAS scores （P<0.05）. No significant differences in CRP, IL-1β, and MMP-3 were noted between the groups preoperatively （P>0.05）; postoperatively, the observation group demonstrated lower levels of CRP, IL-1β, and MMP-3 than the control group （P<0.05）. The total complication rates were 22.22% and 6.67% in the control and observation groups, respectively （P<0.05）. Conclusion In the treatment of lumbar disc herniation, PTED combined with nucleotomy demonstrates superior clinical efficacy, effectively accelerating surgical and postoperative recovery process, improving lumbar function, and reducing inflammatory response and complication rates, which is worth clinical promoting.