Abstract:Objective To investigate the application value of different approaches of unilateral double - channel endoscopic（UBE）in the treatment of recurrent lumbar disc herniation（RLDH）. Methods A total of 108 patients with RLDH in Rugao People??s Hospital Affiliated to Nantong University from October 2019 to October 2023 were selected and divided into transforaminal group and posterior approach group according to random number table method，with 54 cases in each group. The transforaminal group underwent transforaminal UBE，and the posterior approach group underwent via posterior UBE. The perioperative indexes，serum inflammatory indexes［interleukin（IL）- 6，IL - 1β，monocyte chemotactic protein（MCP-1）］，imaging parameters［lumbar lordosis index（LLI），lumbar lordosis angle（Cobb angle）］，pain degree［Visual Analogue Scale（VAS）score］，lumbar function［Oswestry Disability Index（ODI）score］，and the rate of good/excellent at 6 months after surgery and complications were compared between the two groups. Results The intraoperative blood loss and postoperative drainage volume in the transforaminal group were lower than those in the posterior approach group（P<0.05）. On day 1 after operation，the levels of IL-6，IL-1β and MCP-1 in the transforaminal group were lower than those in the posterior approach group（P<0.05）. There were no significant differences in LLI，Cobb angle，VAS score and ODI score between the two groups at 3 and 6 months after surgery（P>0.05）. There was no significant difference in the rate of good/excellence（96.30% vs 94.44% ，χ2=0，P=1.000）and complication rate（5.56% vs 9.26%，χ2=0.135，P=0.713）between transforaminal group and posterior approach group at 6 months after operation. Conclusion The transforaminal approach and posterior approach UBE are safe and reliable treatment measures for RLDH patients，which can restore the shape of the lumbar spine and improve the function of the lumbar spine，while the transforaminal approach can reduce the amount of blood loss and reduce the early postoperative inflammatory response.