Application Of Percutaneous Endoscopic Interlaminar Discectomy Combined With LUSTA Large Channel Endoscopy In The Treatment Of High-Grade Migrated Lumbar Disc Herniation

Objective: The objective of this study was to investigate the efficacy and safety of percutaneous endoscopic interlaminar discectomy combined with LUSTA large channel endoscopy for the treatment of high-grade migrated lumbar disc herniation.Methods: In this retrospective cohort study,28 patients diagnosed with high-grade migrated lumbar disc herniation at L4/5 or L5/S1 from January 2018 to August 2022 were selected.According to the surgical methods,the patients were divided into the percutaneous endoscopic interlaminar discectomy(PEID)group and the percutaneous endoscopic interlaminar discectomy combined with LUSTA large channel endoscopy(LUSTA)group,among which 16 patients were in the PEID group and 12 patients in the LUSTA group.The surgical approaches were all interlaminar approaches.Perioperative data(operation time and intraoperative blood loss)of the two groups were recorded.Patients were followed up to 6 months after surgery.The postoperative lumbar and leg pain of the patients was recorded by VAS score,and the postoperative efficacy of the patients was evaluated by ODI score and modified Mac Nab standard,and statistical and comparative analysis were conducted.Results: The operative time in LUSTA group was significantly shorter than that in PEID group(P<0.05),and the intraoperative blood loss in LUSTA group was less than that in PEID group(P < 0.05).After the respective surgical treatment,VAS score and ODI score in both groups were significantly improved compared with that before surgery(P < 0.05).However,there was no significant difference in VAS score and ODI score between the two groups at the same time after surgery(P > 0.05),and there was no significant difference in the excellent and good rate of modified Mac Nab between the two groups at the last follow-up(P > 0.05).Conclusion: In the treatment of high-grade migrated lumbar disc herniation at L4/5 and L5/S1 levels,both percutaneous endoscopic interlaminar discectomy and percutaneous endoscopic interlaminar discectomy combined with LUSTA large channel endoscopy can achieve satisfactory clinical efficacy.The operation time of percutaneous endoscopic interlaminar discectomy combined with LUSTA large channel endoscopy is shorter,more efficient and less intraoperative bleeding.It is a safe and effective minimally invasive surgical method for the treatment of L4/5 and L5/S1 high-grade migrated lumbar disc herniation.