Abstract:Objective To explore the clinical efficacy of percutaneous endoscopic transforaminal approach in the treatment of patients with upper lumbar intervertebral disc herniation（ULDH）, and to serve as a reference for selecting the optimal treatment plan for ULDH patients. Methods A retrospective analysis was conducted on the clinical data of 27 patients with ULDH treated by percutaneous endoscopic transforaminal approach at the Affiliated Huai'an First People's Hospital of Nanjing Medical University from January 2020 to May 2024. There were 21 male patients and 6 female patients，aged from 21 to 79（57.33 ± 15.32）years. The L2 - 3 segment was involved in 9 cases，and the L3 - 4 segment was involved in 18 cases. Preoperative, 1 - day postoperative，1 - month postoperative，and last follow - up evaluations included assessment of low back and leg pain using the Visual Analog Scale（VAS），and evaluation of lumbar function improvement using the Oswestry Disability Index（ODI）and Japanese Orthopaedic Association（JOA）scores. The modified MacNab functional criteria were used to assess the outcome at the last follow-up. Postoperative complications and recurrence were also recorded. Results All patients successfully completed the surgery，with a follow-up period ranging from 3 to 24 months. During the follow-up period，no complications such as dural sac tear or nerve injury occurred. The main effects of time on VAS for low back pain（F=148.989，P<0.01），VAS for lower limb pain（F=154.236，P<0.01），JOA lumbar score（F=555.144，P<0.01），and ODI（F=1 699.511，P<0.01）were statistically significant. Compared with preoperative values，significant improvements were observed in all four indicators on 1-day postoperative，1-month postoperative，and last follow-up（P<0.05）. At the last follow-up，according to the modified MacNab criteria，20 cases were rated as excellent，5 as good，and 2 as fair，with an excellent-to-good rate of 92.6%.Conclusion The percutaneous endoscopic transforaminal approach for the treatment of ULDH shows significant clinical efficacy，with advantages such as minimal trauma，low blood loss，and rapid postoperative recovery. It is worthy of clinical promotion and application，but suitable case selection is necessary.