目的 分析经皮经椎间孔入路与经椎板间入路内窥镜下椎间盘切除治疗腰5/骶1椎（L₅/S₁）间盘突出症（LDH） 的疗效对比。 方法 采用回顾性病例对照研究，选取2020年6月至2022年12月在亳州医院脊柱外科采用经皮内窥镜手术治疗L₅/S₁ LDH患者62例，其中采用经椎间孔入路 32例（TELD组），采用椎板间入路 30例（IELD组）。观察指标包括术中透视次数、手术时间、住院时间、住院费用、腿痛VAS评分、ODI评分、改良MacNab疗效评价和并发症情况。 结果 62例患者均顺利完成手术和随访，无严重并发症发生。两组间在手术时间、透视次数和住院费用方面差异有统计学意义（P < 0.001），两组住院时间差异无统计学意义（P > 0.05），两组患者术后2 d、1个月及末次随访时下肢VAS评分较术前明显改善（P < 0.001）、两组患者术后2 d、1个月及末次随访时ODI评分较术前明显改善（P < 0.001），但两组间同时间点比较差异无统计学意义（P > 0.05）；两组在手术优良率方面差异无统计学意义（P > 0.05），TELD组有高髂嵴患者11例均顺利完成手术。 结论 经椎间孔入路和经椎板间入路内镜手术治疗L₅/S₁LDH均能取得满意效果。但经椎间孔入路局部麻醉，住院费用少，伴有高髂嵴患者选择合适穿刺路径均可以顺利完成手术。经椎板间入路透视次数少，手术时间较短，但是出现硬脊膜及神经损伤风险较高，对于新手来说需要小心操作。

Objective To compare the efficacy of percutaneous transforaminal approach and translaminar approach in the treatment of L₅/S₁ disc herniation （LDH） under endoscopic discectomy. Methods Adopted a retrospective case-control study， and selected 62 cases of patients with L₅/S₁ LDH who were treated with percutaneous endoscopic surgery in the spine surgery department of our hospital from June 2020 to December 2022， and the transforaminal approach was used. （TELD） in 32 cases （TELD group）， and interlaminar approach （IELD） in 30 cases （IELD group）. The observation indicators included intraoperative fluoroscopy times， operation time， hospitalization days， hospitalization expenses， leg pain VAS score， ODI score， modified MacNab curative effect evaluation and complications. Results All 62 patients successfully completed the operation and follow-up， and no serious complications occurred. There were statistically significant differences in operation time， fluoroscopy times， and hospitalization expenses between the two groups （P < 0.001）， but there was no significant difference in hospitalization days between the two groups （P > 0.05）. The lower extremity VAS scores at the last follow-up and the last follow-up were significantly improved compared with those before operation （P < 0.001）， and the ODI scores of the two groups were significantly improved at 2 days， 1 month and at the last follow-up （P < 0.001）. At the same time point， there was no statistical difference （P > 0.05）； there was no significant difference in the excellent and good rate of surgery between the two groups （P > 0.05）. 11 patients with high iliac crest in the TELD group successfully completed the surgery. Conclusions Both the endoscopic surgery through the intervertebral foramen and the interlaminar approach can achieve satisfactory results in the treatment of L₅/S₁ LDH. However， local anesthesia through the intervertebral foramen approach reduces hospitalization costs， and patients with high iliac crest can successfully complete the surgery by selecting a suitable puncture path. The translaminar approach has fewer fluoroscopy times and shorter surgical time， but there is a higher risk of dura mater and nerve damage， which requires careful operation for beginners.