Clinical Observation of Influence of Percutaneous Endoscopic Transforaminal Discectomy on Functional Spinal Unit

Ma Zikun; Fan Zhiyuan; Lu Zhixiang

doi:10.3969/j.issn.1004-5775.2025.18.006

Abstract：Objective:To investigate the influence of percutaneous endoscopic transforaminal discectomy(PETD)on functional spinal unit.Methods:The data of patients with lumbar disc herniation(LDH)in the hospital were retrospectively analyzed.According to the surgical methods,they were divided into fenestration and discectomy(FD)group and PETD group.The propensity score matching method was used to balance the confounding bias caused by the differences of baseline characteristics between groups,with 43 patients in each group.The clinical efficacy,clinical surgical indicators,and functional spinal unit[intervertebral space height(ISH),intervertebral foramen height(FH),facet joint space difference(DID),facet joint angle difference(DFJA)]were compared between groups.Results:There was no statistically significant difference in the excellent and good rate between the two groups(χ2=0.496,P＞0.05).The operation time of the PETD group was higher than that of the FD group,while the intraoperative blood loss,incision length and postoperative hospital stay were all lower than those of the FD group.The differences were statistically significant(t=3.439,4.687,18.701,6.857;P＜0.05).After the operation,ISH and FH in both groups decreased significantly,and the decrease in the PETD group was lower than that in the FD group.The differences were statistically significant(t=4.604,4.299,7.705,13.198;P＜0.05).Conclusion:Compared with FD,PETD has the advantages of minimally invasion,small vertebral injury and fast postoperative recovery,and can better maintain the functional spinal unit.However,it is difficult to operate,and the clinical experience and technical requirements of the operator are high.