To compare the efficacy of transforaminal Kirschner-wire guided endoscopic external trephination (ET) versus the transforaminal endoscopic spine system (TESSYS) in the treatment of lumbar disc herniation (LDH).

From January 2016 to December 2018, a retrospective analysis was carried out on 107 patients with LDH who underwent TESSYS or ET treatment. The patients were divided into either a TESSYS group (59 cases) or an ET group (48 cases). The t-test was used to compare the number of intraoperative fluoroscopies, operation duration, and visual analogue scale (VAS) and Oswestry disability index (ODI) scores at 48 h, 3 months, and 6 months after surgery between the two groups.

All surgeries were carried out successfully. The average number of intraoperative fluoroscopies and mean operation time were significantly less in the ET group than in TESSYS group [(11.9±1.8) times vs (16.3±2.4) times, t=10.518, P<0.001; (64.8±5.6) min vs (82.3±7.2) min, t=13.782, P<0.001)]. All of the 107 cases were followed for at least 6 months after surgery. The VAS and ODI scores at postoperative 48 h, 3 months, and 6 months in both groups were all significantly lower than the preoperative scores, but the VAS and ODI scores between different postoperative time points (48 h, 3 months, and 6 months) were not significantly different (P>0.05).

Both TESSYS and ET can achieve good clinical efficacy in the treatment of LDH. ET has a simpler operative procedure, shorter operation time, and fewer fluoroscopies than TESSYS.