单孔非同轴脊柱内镜下治疗L5/S1节段 极外侧型腰椎间盘突出：1例报告

Uni-Portal Non-Coaxial Spinal Endoscopic Surgery for the Treatment of an Extremely Lateral Type L5/S1 Lumbar Disc Herniation: A Case Report

摘要: 目的：探讨单孔非同轴脊柱内镜(UNSES)治疗L5/S1节段极外侧型腰椎间盘突出症(FLLDH)的临床疗效与手术优势。方法：回顾性分析云南中医药大学第一附属医院2025年2月收治的1例68岁L5/S1节段FLLDH女性患者的临床资料，对其实施单孔非同轴内镜下经远外侧入路髓核摘除 + 神经根减压 + 椎管根管减压术，术后随访观察手术相关指标、功能评分及影像学变化。结果：手术顺利完成，无严重并发症，手术切口1.5 cm、术中出血量52 mL、手术时间73 min、术后住院3 d，均符合UNSES治疗该疾病的核心指标范围。神经根松解彻底，无突出物残留。结论：UNSES治疗L5/S1节段FLLDH具有创伤小、出血少、术后恢复快、减压彻底的特点，且能最大限度保留脊柱稳定性，并发症风险低，临床近期疗效显著，值得临床研究与推广，其远期疗效仍需大样本临床随访验证。

Abstract: Objective: To investigate the clinical efficacy and surgical advantages of Uni-portal Non-coaxial Spinal Endoscopic Surgery (UNSES) in treating extremely lateral lumbar disc herniation (FLLDH) at the L5/S1 segment. Methods: A retrospective analysis was conducted on the clinical data of a 68-year-old female patient with L5/S1 segment FLLDH admitted to the First Affiliated Hospital of Yunnan University of Chinese Medicine in February 2025. She underwent single-port non-coaxial endoscopic discectomy via a far-lateral approach combined with nerve root decompression and spinal canal decompression. Postoperative follow-up monitored surgical parameters, functional scores, and imaging changes. Results: The procedure was completed successfully without major complications. The 1.5 cm incision, 52 mL intraoperative blood loss, 73-minute duration, and 3-day hospitalization all met the core criteria for UNSES treatment of this condition. Thorough nerve root release achieved with no residual disc material. Conclusion: UNSES for L5/S1 FLLDH offers advantages including minimal trauma, low blood loss, rapid postoperative recovery, and thorough decompression. It maximally preserves spinal stability with low complication risk and demonstrates significant short-term clinical efficacy, warranting further clinical research and adoption. Long-term outcomes require validation through large-scale clinical follow-up.