为比较经皮内镜下椎板间入路腰椎间盘切除术中不同黄韧带处理方法的临床效果。通过回顾性分析自2015年3月—2019年3月，行经皮内镜下椎板间入路腰椎间盘切除术的86例L₅-S₁节段腰椎间盘突出症（LDH）患者。根据术中黄韧带的不同处理方法，分为对照组（n=55）和改良组（n=31）。分析对比两组患者之间的年龄构成、性别差异、病程、手术的时程、术中的出血、住院的时间和并发症。术后1、3、6个月常规门诊复查随访。手术结果的评价采用数字评定法（numeric rating scale, NRS）和改良Macnab标准。数据的处理采用统计学分析软件SPSS 19.0，mean±SD表示计量资料，独立样本t检验用于组间的对比，比较手术前后多次测量NRS评分采用数据方差分析。计数资料采用百分率的形式描述，组间对比应用精确概率法或χ²检验；Mann-Whitney秩和检验用于比较各组间的随访时间和等级分组资料。结果表明：疼痛评分：两组患者术后均明显下降（组内总体方差值F_within＝197.477，P＝0.001），两组之间术后疼痛评分比较没有明显差别（组间总体方差值F_interg＝1.701，P=0.203），时间因素对于两组结果的影响并没有不同（交互效应值F_inter=2.231，P＝0.108）。术后6个月，改良组NRS评分明显低于对照组（t=2.086，P=0.046）。两组患者术后改良Macnab标准比较并没有明显不同（术后结果的分布情况U=782.000，P=0.308）。可见经椎板间入路腰椎间盘切除术中采用改良的黄韧带处理技术与传统方法相比不会延长手术时间或者增加手术出血量，在去除突出椎间盘的同时，能够保留相关组织结构的完整性，具有良好的临床效果，符合微创的核心理念。

In order to compare the clinical effect of different surgical technique of ligamentum flavum in percutaneous endoscopic interlaminar lumbar discectomy. From March 2015 to March 2019, 86 cases of L₅-S₁ lumbar disc herniation (LDH) were analyzed retrospectively. According to the different treatment of ligamentum flavum during operation, the patients were divided into control group(n = 55) and modified group (n = 31). The age, gender, course of disease, duration of surgery, intraoperative bleeding, hospital stay, and surgical related complications between the two groups of patients were analyzed and compared. One month, three months and six months after the operation, the routine outpatient reexamination and follow-up were carried out. Numerical rating scale(NRS) and modified macnab were used to evaluate the effect of operation. SPSS 19.0 was used to process the data. Mean ± SD was used for measurement data. Comparison between groups using independent sample t-test, and analysis of variance of repeated measurement data was used for the NRS score comparison before and after operation. The counting data were expressed in percentage, Fisher exact test orχ² test were used for comparison between groups, and Mann Whitney rank sum test was used for comparison of follow-up time and grade grouping data between groups. The results show that the postoperative pain score of both groups decrease significantly(overall variance within the group F_within = 197.477, P = 0.001). There is no difference between the two groups (inter group overall variance value F_interg = 1.701, P = 0.203). The time factor has no effect on the results of the two groups (Interaction effect value F_inter = 2.231, P = 0.108). The NRS score of the modified group is significantly lower than that of the control group (t = 2.086, P = 0.046). According to modified Macnab criteria, there is no significant difference between the two groups (distribution of postoperative outcomes U = 782.000, P = 0.308). It is concluded that the modifiedsurgical technique of ligamentum flavum in the PEILD will not prolong the operation time or increase the amount of bleeding. While removing the herniated intervertebral disc, it can preserve the integrity of the relevant tissue structure, achieve satisfied clinical effect, and conforms to the core concept of minimally invasive surgery.