One-hole split endoscope surgery with the aid of digital 3D technology for highly migrated lumbar disc herniation

Zhao Jiaqing; Liu Dong; Lu Suni; Wang Dawei; Geng Xiaopeng; Ning Huaxiu

doi:10.12307/2025.851

Abstract：BACKGROUND:The use of one-hole split endoscope technique for highly mobile lumbar intervertebral disc herniation is a feasible treatment option,but there are few reports comparing one-hole split endoscope with traditional methods using 3D digital technique. OBJECTIVE:To compare clinical effects of 3D digital technique assisted one-hole split endoscope surgery and traditional one-hole split endoscope surgery in the treatment of highly migrated lumbar disc herniation. METHODS:A retrospective analysis was performed on 52 patients with highly migrated lumbar disc herniation who underwent one-hole split endoscope surgery from June 2022 to June 2023,including 22 patients with 3D digital technology assisted one-hole split endoscope(observation group)and 30 patients with traditional one-hole split endoscope(control group).Operation time,intraoperative blood loss,retention rates of lateral facet,visual analog score and Oswestry Disability Index of lower limb pain and efficacy at the last follow-up(modified MacNab criteria)were used as the main indicators of clinical efficacy to evaluate the clinical effects of the two methods. RESULTS AND CONCLUSION:(1)All 52 patients completed the operation successfully.There were two cases of calf intermuscular vein thrombosis in the observation group and three cases in the control group.All patients were given anticoagulant therapy and symptomatic treatment such as delayed ambulation.No other complications such as dural tear or infection occurred.(2)There was no significant difference in operation time,intraoperative blood loss,and modified MacNab criteria between the two groups(P＞0.05).(3)The lateral articular surface preservation rate of the observation group was(88.9%±7.8)%,which was significantly higher than that of the control group(83.8±8.0)%,and the differences were significant(P＜0.05).(4)The visual analog scale score and Oswestry disability index of lower limb pain in both groups were significantly improved 3 and 6 months after surgery compared with those before surgery(P＜0.05),but there was no significant difference between the two groups(P＞0.05).(5)It is indicated that one-hole split endoscope is a safe and effective treatment for highly migrated lumbar disc herniation.As an auxiliary tool,3D digital technique can help surgeons better protect facet joints and provide possibilities for reducing complications.