Comparison of the efficacy of percutaneous transforaminal endoscopic discectomy in treating upper lumbar disc herniation versus lower lumbar disc herniation
LI Wenqing
BU Baoxian
Abstract：Objective To compare the clinical efficacy of percutaneous transforaminal endoscopic discectomy(PTED)in treating upper lumbar disc herniation(ULDH)and lower lumbar disc herniation(LLDH),and to validate the differences in effectiveness and safety of PTED for lumbar disc herniation(LDH)at different spinal levels.Methods Clinical data of 84 patients who underwent PTED between January 2020 and January 2024 were retrospectively analyzed.All patients were preoperatively diagnosed with ULDH(L1-2,L2-3)or LLDH(L4-5)via imaging.Of them,42 ULDH patients were involved into ULDH group,and then 42 patients in LLDH group were matched 1:1 by gender and age.Patients were followed up for 1 year postoperatively.Outcomes were evaluated using visual analogue scale(VAS),Oswestry disability index(ODI)and MacNab criteria.Results No statistical differences were found in operative time or postoperative hospital stay between two groups(P>0.05).Transient postoperative sensory abnormalities occurred in two patients in ULDH group and one patient in LLDH group,with no severe complications reported.There was no statistical difference of complication incidence between two groups(P>0.05).In both groups,there were significant improvements in VAS scores for low back pain and leg pain at 1 day and 1 year postoperatively,as well as in ODI at 1 year postoperatively,compared to the preoperative levels(all P<0.05).Furthermore,VAS scores for low back pain and leg pain at 1 year postoperatively showed significant improvement compared to those at 1 day postoperatively(all P<0.05).However,there were no statistical differences between the two groups in these three outcome indicators before and after the surgery(all P>0.05).The excellent-good rate was 88.10%in ULDH group and 92.86%in LLDH group,with no significant difference between the groups(P=0.713).Conclusion PTED has been demonstrated to obtain comparable short-term efficacy and safety in the treatment of ULDH and LLDH,with no significant differences in pain relief,functional recovery,or complication rates.
Keywords：DiskectomypercutaneousIntervertebral disc displacementUpper lumbar vertebraeLower lumbar vertebraeEndoscopyMinimally invasive surgical procedures
Publication Date：2025-10-15
Online Publishing Date：2026-04-01(First online date of this platform, not the publication date of the document)
Pages：7( 305-311 )