【摘要】 目的：对比不同入路行脊柱内镜手术治疗L₅/S₁椎间盘突出症的临床效果。方法：选取2021年1月—2024年12月于玉林市第一人民医院行脊柱内镜手术的L₅/S₁椎间盘突出症患者65例，根据随机数字表法分为椎板间组（n=32）、椎间孔组（n=33）。椎间孔组经椎间孔入路行脊柱内镜手术，椎板间组经椎板间入路行脊柱内镜手术。比较两组治疗效果。结果：两组治疗总有效率比较，无统计学差异（P>0.05）；与椎间孔组相比，椎板间组手术时间更短，术中出血量、透视次数更少（P<0.001）；两组首次下床活动时间、住院时间对比，无统计学差异（P>0.05）；术后3个月，两组视觉模拟评分法及Oswestry功能障碍指数评分对比，无统计学差异（P>0.05）。结论：L₅/S₁椎间盘突出症患者采取经椎板间、经椎间孔入路行脊柱内镜手术均可获得较好的治疗效果，其中经椎板间入路术中出血量与透视次数更少,手术时间更短。更多还原

【Abstract】 Objective: To compare the clinical outcomes of spinal endoscopic surgery via different approaches for treating L₅/S₁ intervertebral disc herniation. Methods: A total of 65 patients with L₅/S₁ intervertebral disc herniation who underwent spinal endoscopic surgery at the First People’s Hospital of Yulin between January 2021 and December 2024 were selected. They were divided into interlaminar group（n=32） and transforaminal group（n=33） according to random number table method. The interlaminar group underwent spinal endoscopic surgery via an interlaminar approach, while transforaminal group underwent spinal endoscopic surgery via a transforaminal approach. The therapeutic effects were compared between the two groups. Results: There was no statistically significant difference in the overall response rate of treatment between the two groups（P>0.05）. Compared with the transforaminal group, the interlaminar group had shorter operation time, less intraoperative blood loss, and less fluoroscopy times（P<0.001）.There was no statistically significant difference in the first ambulation time and length of hospital stay between the two groups（P>0.05）. At 3 months after surgery, there was no statistically significant difference in visual analogue scale and Oswestry disability index scores between the two groups（P>0.05）. Conclusion: Both the interlaminar and transforaminal approaches for spinal endoscopic surgery in patients with L₅/S₁ intervertebral disc herniation can achieve good therapeutic effects. The interlaminar approach has less intraoperative blood loss, less fluoroscopy times, and shorter operation time.更多还原