Abstract：Objective To investigate the feasibility and clinical effect of percutaneous foraminoscope assisted lower foraminal approach of lumbar disc herniation with posterior vertebral margin disarticulation.Methods A total of 63 patients with lumbar disc herniation with posterior lumbar spine margin dissociation treated by percutaneous transforaminal approach from January 2018 to December 2020, including 21 patients at L3-4 segment and 42 patients at L4-5 segment, were retrospectively reviewed. Postoperative follow-up was evaluated according to MacNab scoring standard. The scores of patients' preoperative and final Oswestry disability index (ODI) and visual analog scale (VAS) of lumbar pain were compared.Results Sixty-three patients were followed for 6-14 months with a mean follow-up time of (11.8±1.4) months. The pain VAS score at the last follow-up was 0-2, with a mean of (0.9±0.3) points; the ODI index was 14% - 28% with a mean (19.7±3.8)% of the patients, and all the scores were significantly improved compared with those before operation, with statistical significance (P<0.05). The follow-up effect was evaluated by MacNab scoring standard: excellent in 56 cases, good in 6 cases, poor in 1 case, and the excellent and good rate was 98.4%.Conclusions Percutaneous foraminal approach assisted by endoscope is safe to treat lumbar disc herniation with vertebral posterior margin disconnection, and patients can recover quickly after surgery, which is worthy of further research and promotion.
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2023, Vol. 34 
