Comparison of the efficacy of arthroscopic-assisted uni-portal spinal surgery and percutaneous endoscopic lumbar discectomy in the treatment of far lateral lumbar disc herniation: a retrospective controlled study.

purposeTo analyze the clinical efficacy of arthroscopic-assisted uni-portal spinal surgery (AUSS) in the treatment of far lateral lumbar disc herniation (FLLDH).

methodsA retrospective analysis was conducted on 120 cases of FLLDH patients. The patients were divided into two groups based on the treatment methods: the control group (CG, n = 68) underwent percutaneous endoscopic lumbar discectomy (PELD), while the study group (SG, n = 52) received nucleus pulposus removal under the AUSS technique. Perioperative indicators, 6-month postoperative efficacy rate, and postoperative complications were collected and compared between the two groups. Additionally, preoperative and postoperative patient assessments included pain levels [Visual Analogue Scale (VAS)], Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score and lumbar mobility.

resultsCompared to the CG, the SG demonstrated a shorter operative time, as well as reduced time to ambulation and postoperative hospital stay (P < 0.05), while there was no statistically significant difference in intraoperative blood loss between the two groups (P > 0.05). The overall efficacy rate at 6 months postoperatively in the SG (94.23%) was higher than that in the CG (79.41%) (P < 0.05). The incidence of postoperative complications in the SG (5.77%) was lower than that in the CG (19.12%) (P < 0.05). At 3 and 6 months postoperatively, the SG showed lower VAS and ODI scores and higher JOA scores than the CG (P < 0.05). The ranges of motion for left lateral bending, flexion, extension, and right lateral bending of the SG were greater than those of the CG at 3 and 6 months postoperatively (P < 0.05).

conclusionThe AUSS technique demonstrates superior efficacy over PELD in the treatment of FLLDH, effectively alleviating pain, enhancing functional outcomes, and improving quality of life, with a lower incidence of complications. Its minimally invasive nature and remarkable recovery efficiency highlight its promising clinical potential, warranting further validation of long-term outcomes through prospective follow-up studies.