关键词: 腰椎间盘突出症, 经皮腰椎间孔镜手术, 椎间盘区域定位分型, 术后预后

Abstract: Objective This study aims to improve the accuracy of preoperative evaluation for percutaneous endoscopic lumbar discectomy （PELD） through a modified regional localization and classification method for intervertebral discs, providing a new basis for individualized prediction of postoperative functional recovery and recurrence risk for patients. Methods This is a retrospective cohort study including 113 patients with LDH who underwent PELD treatment at Shenshan Medical Center, Sun Yat-sen Memorial Hospital,Sun Yat-sen University, between January 1, 2022, and September 30, 2023. The regional localization and classification method was applied based on imaging data to record the position and most protruding point of the intervertebral disc in the sagittal, transverse, and coronal planes. Through preoperative imaging data and clinical evaluations （VAS score, JOA score, ODI score, etc.）, the impact of regional localization and classification on postoperative recovery and prognosis was systematically analyzed. Results L5/S1 and L4/5 were the most commonly affected segments among LDH patients. Furthermore, the most protruding point of the intervertebral disc could effectively predict patients' functional recovery at 1 year postoperatively, as indicated by VAS score （P=0.039）, JOA score （P=0.031）, and ODI score （P=0.045）. Additionally, PELD surgery reduced intraoperative blood loss, shortened hospital stay, and contributed to rapid recovery for patients. Conclusion This study suggests that the modified regional localization and classification method can provide a new predictive approach for different patients with intervertebral disc herniation undergoing PELD surgery, thereby assessing prognostic differences and potential recurrence probabilities among various patients.

Key words: lumbar disc herniation, percutaneous endoscopic lumbar discectomy, regional localization and classification of intervertebral discs, postoperative prognosis