BACKGROUND:Currently,spinal endoscopic technology has become the mainstream technology in minimally invasive spinal surgery.The specifications of the instruments for different operating systems are different,and the choice of specific surgical protocols needs to be combined with the actual situation of the patient and the choice of the clinical surgeon. OBJECTIVE:To compare the early efficacy of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation under the iLESSYS Delta System and Endo-Surgi Plus System. METHODS:Totally 80 patients with L5-S1 disc herniation were treated with percutaneous endoscopic interlaminar discectomy.Patients were divided into two groups based on the endoscopic system used.Among them,37 cases received the iLESSYS Delta System(Delta group)and 43 cases received the Endo-Surgi Plus System(Plus group).Patient demographic characteristics,perioperative indicators,and complications were analyzed between the two groups.Clinical outcomes were quantified using back and leg visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores at 1 day,1,3,and 6 months after surgery.Patient satisfaction was assessed according to modified MacNab criteria at final follow-up. RESULTS AND CONCLUSION:(1)The operative time and number of arthroplasties in the Plus group were less than those in the Delta group,and the differences were statistically significant(P<0.05).(2)Compared with the preoperative period,the visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in both groups improved at all follow-up time points,and the difference was statistically significant(P<0.001).(3)There was no statistically significant difference in the comparison of pain visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in the two groups(P>0.05).(4)At 6-month follow-up after surgery,the MacNab standard excellent and good rates in the Delta group and Plus group were 81%and 79%,respectively,with no significant difference(P=0.823).(5)The incidence of complications was 3%in the Delta group and 2%in the Plus group,but there was no significant difference between the two groups(P=0.914).(6)It is concluded that both iLESSYS Delta and Endo-Surgi Plus surgical systems achieved satisfactory early clinical results in the treatment of lumbar disc herniation,with Endo-Surgi Plus surgical moulding being more efficient and safer.

Objectives:To investigate the clinical efficacy of visual working channel assisted percutaneous transforaminal endoscopic discectomy(PTED)in treating lumbar disc herniation(LDH).Methods:The medical records of 141 LDH patients who underwent PTED between June 2022 and June 2023 were retrospectively analyzed.The patients were divided into two groups of the visual group consisting of 68 cases(38 males and 30 females,with an average age of 48.0±15.9 years),and the transparent visual working channel was applied in PTED;And the traditional group including 73 cases(46 males and 27 females,with an age of 47.6±16.9 years),and the traditional metal working channel was applied in PTED.There was no statistical difference in the general data(gender,age,etc)between the two groups(P＞0.05).The operative time,intraoperative blood loss,postoperative length of hospital stay,and complication occurrence were compared between the two groups.The degree of low back pain was assessed using the visual analogue scale(VAS)score for pain,and the lumbar spine function was assessed using the Oswestry disability index(ODI)before operation,at one week and,1,3,and 6 months after surgery,and final follow-up,respectively.The MacNab criteria were used to assess the clinical outcomes of patients at the final follow-up.Results:The operative time,intraoperative blood loss,and postoperative length of hospital stay in the visual group was all less than those in the traditional group(71.06±8.97min vs 75.16±9.47min,14.19±2.66mL vs 15.58±2.81mL,2.16±0.96d vs 2.54±1.23d),and the differences were statistically significant(P＜0.05).The VAS scores and ODI one week after surgery,1,3,and 6 months after surgery,and at the final follow-up were significantly improved compared with the preoperative values in both groups(P＜0.05).At the final follow-up,the VAS score and ODI in the visual group were significantly improved compared with those in the traditional group[1.18±0.39 vs 1.27±0.45,(3.97±1.67)％vs(4.54±1.55)％],and the differences were statistically significant(P＜0.05).According to the MacNab criteria at the final follow-up,53 cases in the visual group were excellent,12 cases were good,and 3 cases were possible,with an excellent and good rate of 95.6％;52 cases in the traditional group were excellent,15 cases were good,4 cases were possible,and 2 cases were poor,with an excellent and good rate of 91.8％(P＞0.05).No surgery-related complications occurred in the visual group and 4 cases of nerve root irritation signs and 2 cases of postoperative recurrence occurred in the traditional group;The complication rate of the traditional group was 8.2％,and the complication rate of the visual group was lower than that of the traditional group,and the difference was statistically significant(P＜0.05).Conclusions:The visual working channel assisted PTED has the advantages of short operative time,little intraoperative bleeding,fast postoperative recovery,and few complications in treating LDH.

Objective An innovative transparent full-visualization working channel was developed to investigate the clinical efficacy of applying a transparent full-visualization working channel in percutaneous endoscopic interlaminar discectomy(PEID)for the treatment of lumbar disc herniation.Methods The medical records of 145 patients who underwent PEID for lumbar disc herniation from September 2023 to September 2024 were included.These patients were classified into two groups based on the use of a transparent full-visualization working channel or a metal working channel:69 cases in the transparent channel group and 76 cases in the metal channel group.A comparative analysis was carried out between the two groups,evaluating differences in baseline characteristics,surgical performance indicators,the incidence of postoperative complications,and overall treat-ment outcomes.Results The operative time in the transparent channel group was shorter than that in the metal channel group,and the difference was statistically significant(P<0.05).Regarding the length of postoperative hospital stays and the frequency of intraoperative fluoroscopy,no significant differences were observed between the transparent and metal channel groups(P>0.05).In the transparent channel group,postoperative sensory abnormalities in the lower extremities occurred in one patient,while in the metal channel group,seven patients experienced such issues.Nevertheless,this difference in complication rates did not reach statistical significance(P>0.05).Similarly,no significant differences were detected in EMG electrophysiological alerts during the place-ment of the working channel and nerve exploration between the two groups(P>0.05).However,during intraop-erative decompression,the transparent channel group had 8 fewer EMG alarms compared to the metal channel group's total of 29,and this difference was statistically significant(P<0.05).Conclusions The application of a transparent fully visualized working channel in the transforaminal approach for PEID can achieve the same clinical efficacy as a metal working channel.Moreover,it can significantly reduce nerve root irritation.The microscopic field of view of the transparent working channel is notably superior to that of the metal working channel.This enhanced visibility expands the field of view,facilitating effective nerve observation and protection,and ultimately increasing the safety of the surgical procedure.

Objective An innovative transparent full-visualization working channel was developed to investigate the clinical efficacy of applying a transparent full-visualization working channel in percutaneous endoscopic interlaminar discectomy(PEID)for the treatment of lumbar disc herniation.Methods The medical records of 145 patients who underwent PEID for lumbar disc herniation from September 2023 to September 2024 were included.These patients were classified into two groups based on the use of a transparent full-visualization working channel or a metal working channel:69 cases in the transparent channel group and 76 cases in the metal channel group.A comparative analysis was carried out between the two groups,evaluating differences in baseline characteristics,surgical performance indicators,the incidence of postoperative complications,and overall treat-ment outcomes.Results The operative time in the transparent channel group was shorter than that in the metal channel group,and the difference was statistically significant(P<0.05).Regarding the length of postoperative hospital stays and the frequency of intraoperative fluoroscopy,no significant differences were observed between the transparent and metal channel groups(P>0.05).In the transparent channel group,postoperative sensory abnormalities in the lower extremities occurred in one patient,while in the metal channel group,seven patients experienced such issues.Nevertheless,this difference in complication rates did not reach statistical significance(P>0.05).Similarly,no significant differences were detected in EMG electrophysiological alerts during the place-ment of the working channel and nerve exploration between the two groups(P>0.05).However,during intraop-erative decompression,the transparent channel group had 8 fewer EMG alarms compared to the metal channel group's total of 29,and this difference was statistically significant(P<0.05).Conclusions The application of a transparent fully visualized working channel in the transforaminal approach for PEID can achieve the same clinical efficacy as a metal working channel.Moreover,it can significantly reduce nerve root irritation.The microscopic field of view of the transparent working channel is notably superior to that of the metal working channel.This enhanced visibility expands the field of view,facilitating effective nerve observation and protection,and ultimately increasing the safety of the surgical procedure.

Objectives:To investigate the clinical efficacy of visual working channel assisted percutaneous transforaminal endoscopic discectomy(PTED)in treating lumbar disc herniation(LDH).Methods:The medical records of 141 LDH patients who underwent PTED between June 2022 and June 2023 were retrospectively analyzed.The patients were divided into two groups of the visual group consisting of 68 cases(38 males and 30 females,with an average age of 48.0±15.9 years),and the transparent visual working channel was applied in PTED;And the traditional group including 73 cases(46 males and 27 females,with an age of 47.6±16.9 years),and the traditional metal working channel was applied in PTED.There was no statistical difference in the general data(gender,age,etc)between the two groups(P＞0.05).The operative time,intraoperative blood loss,postoperative length of hospital stay,and complication occurrence were compared between the two groups.The degree of low back pain was assessed using the visual analogue scale(VAS)score for pain,and the lumbar spine function was assessed using the Oswestry disability index(ODI)before operation,at one week and,1,3,and 6 months after surgery,and final follow-up,respectively.The MacNab criteria were used to assess the clinical outcomes of patients at the final follow-up.Results:The operative time,intraoperative blood loss,and postoperative length of hospital stay in the visual group was all less than those in the traditional group(71.06±8.97min vs 75.16±9.47min,14.19±2.66mL vs 15.58±2.81mL,2.16±0.96d vs 2.54±1.23d),and the differences were statistically significant(P＜0.05).The VAS scores and ODI one week after surgery,1,3,and 6 months after surgery,and at the final follow-up were significantly improved compared with the preoperative values in both groups(P＜0.05).At the final follow-up,the VAS score and ODI in the visual group were significantly improved compared with those in the traditional group[1.18±0.39 vs 1.27±0.45,(3.97±1.67)％vs(4.54±1.55)％],and the differences were statistically significant(P＜0.05).According to the MacNab criteria at the final follow-up,53 cases in the visual group were excellent,12 cases were good,and 3 cases were possible,with an excellent and good rate of 95.6％;52 cases in the traditional group were excellent,15 cases were good,4 cases were possible,and 2 cases were poor,with an excellent and good rate of 91.8％(P＞0.05).No surgery-related complications occurred in the visual group and 4 cases of nerve root irritation signs and 2 cases of postoperative recurrence occurred in the traditional group;The complication rate of the traditional group was 8.2％,and the complication rate of the visual group was lower than that of the traditional group,and the difference was statistically significant(P＜0.05).Conclusions:The visual working channel assisted PTED has the advantages of short operative time,little intraoperative bleeding,fast postoperative recovery,and few complications in treating LDH.