Objective: To introduce the concept of 'nerve root as the core' and to investigate the surgical procedure and curative effect of percutaneous translaminar endoscopic discectomy (PTED) surgery in the treatment of different types of lumbar disc herniation (LDH).
Methods: This retrospective study analysed the clinical data from patients with LDH that underwent single-segment PTED surgery. They were divided into three groups based on LDH location: central canal zone group, lateral recess zone group and foraminal/far lateral zone group. Different working cannula placement methods were used for the different types of LDH. All patients were followed for at least 12 months. Clinical and follow-up data were compared between the three groups.
Results: A total of 130 patients were enrolled in the study: 44 (33.8%) in the central canal zone group, 72 (55.4%) in the lateral recess zone group and 14 (10.8%) in the foraminal/far lateral zone group. All three groups of patients achieved good postoperative results. The improvements in leg pain and disability were most marked in the first postoperative month in all three groups.
Conclusion: PTED achieved adequate decompression for different types of LDH. The concept of 'nerve root as the core' facilitated the accurate placement of the working cannula.
Keywords: Lumbar disc herniation; minimally invasive; percutaneous transforaminal endoscopic decompression; puncture.