ObjectiveTo compare the short-term clinical efficacy of intervertebral foraminal endoscopic surgery via transiliac drilling approach versus lamina fenestration discectomy via traditional posterior approach for L5/S1 disc herniation with high iliac crest. MethodsSeventy-two patients, conformed to the characteristics of high iliac crest by X-ray measurement, who underwent surgery for L5/S1 disc herniation were randomly assigned to observation group or control group, with 36 cases in each group. Among them, the observation group was treated with intervertebral foraminal endoscopic surgery via transiliac drilling approach, while the control group was treated with lamina fenestration discectomy via traditional posterior approach. The perioperative parameters, including operation time, fluoroscopy times, intraoperative blood loss, the VAS scores and the Oswestry disability index (ODI) one week and one month after surgery, as well as complications and satisfaction were compared between the two groups. ResultsCompared to the control group, the observation group obtained longer operation time, more intraoperative fluoroscopy times, and less intraoperative blood loss (all P＜0.05). The VAS scores and ODI one week and one month after surgery decreased in both groups compared to those before surgery(all P＜0.05), but there were no statistically significant differences in VAS scores, ODI, complications or satisfaction between the two groups (all P＞0.05). ConclusionFor patients suffering from L5/S1 disc herniation with high iliac crest, intervertebral foraminal endoscopic surgery via transiliac drilling approach is an ideal approach, which can better decompress intervertebral disc and release nerve root, achieve a similar short-term clinical efficacy to lamina fenestration discectomy via traditional posterior approach, and with less intraoperative blood loss.

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