Application of Percutaneous Transforaminal Endoscopic Discectomy in Patients with Lumbar Disc Herniation

Wang Bing; Chen Lijun; Cai Jianqiang

doi:10.3969/j.issn.1004-5775.2025.05.005

Abstract：Objective:To study the application effect of percutaneous foraminal endoscopy in the removal of the nucleus pulposus in patients with lumbar disc herniation.Methods:A retrospective study was conducted on 99 patients with lumbar disc herniation treated in the hospital from January 2022 to January 2023.They were divided into control group(n=48)and observation group(n=51)based on different surgical methods.The control group underwent laminoplasty,while observation group underwent percutaneous foraminal endoscopic removal of the nucleus pulposus.Perioperative indicators,lumbar spine function before and after surgery,lumbar range of motion,and inflammatory response between two groups[interleukin-17(IL-17),tumor necrosis factor-γ(TNF)-γ,Interleukin-4(IL-4)],pain mediator[5-hydroxytryptamine(5-HT)β-levels of endorphins,substance P(SP)],and complications occurrence of two groups were compared.Results:Compared with the control group,incision length,time to get out of bed,surgery time and hospital stay,and less blood transfusion volume of the observation group are less(t=31.274,16.050,9.355,28.098,20.591;P＜0.05).1 week after surgery,the serum levels of TNF-γ and IL-17 in the observation group were lower than those in the control group,and the serum levels of IL-4 were higher than those in the control group,with statistically significant difference(t=6.039,5.715,8.689;P＜0.05).1 week after surgery,the levels of 5-HT and SP of the observation group were lower than those in the control group,and the levels of β-endorphin in the control group were higher,with statistically significant difference(t=2.091,6.877,5.037;P＜0.05).There was no significant difference in the incidence of complications between two groups(x2=0.323,P＞0.05).Conclusion:Percutaneous lumbar discectomy can promote the recovery of lumbar function in patients with lumbar disc herniation,alleviate inflammatory reactions,reduce postoperative pain.