ObjectiveTo investigate the application value of transforaminal endoscopic surgery via the top point approach of Kambin triangle in the lumbar disc herniation for high-grade up-migrated nucleoid. MethodsThe clinical data of 76 patients with lumbar disc herniation for high-grade up-migrated nucleoid were retrospectively analyzed, among which 38 patients underwent transforaminal endoscopic surgery via the top point approach of Kambin triangle were enrolled in observation group, whereas 38 patients, whose baseline data matched with the observation group, undergoing transforaminal endoscopic surgery via interlaminar approach were enrolled in control group. The intraoperative blood loss volume, incision length, surgery duration, postoperative in-bed time, hospital stays, and VAS scores of lumbago and lower limb pain before and after surgery were compared between the two groups. ResultsThere were no statistically significant differences in intraoperative blood loss volume, surgery duration, postoperative in-bed time, and hospital stays between the two groups (all P＞0.05). The incision length of the observation group was shorter than that of the control group (P＜0.05). There were no statistically significant differences in the VAS scores of lumbago and lower limb pain before surgery, 24 h and 1 year after surgery between the two groups (all P＞0.05); however, the scores mentioned above in the two groups were significantly lower after 24 h and 1 year of surgery than before surgery (all P＜0.05). ConclusionTransforaminal endoscopic surgery via the top point approach of Kambin triangle and via interlaminar approach in the treatment of lumbar disc herniation for high-grade up-migrated nucleoid has a prominent efficacy. Individualized treatment scheme can be selected according to the actual situation of patients in the clinic.

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