Objective To explore the postoperative management characteristics of patients with lumbar disc herniation treated with full-endoscopic spinal surgery under day surgery and its correlation with prognosis to provide the clinical evidence for the standardized application of this surgical procedure in day surgery and optimization of postoperative management plans.

Methods A retrospective analysis was conducted on patients with lumbar disc herniation who underwent full-endoscopic spinal surgery in the Department of Orthopedics of our hospital between January 2020 and January 2022. According to the surgical management model, the patients were divided into the day-surgery group (ambulation approximately 2 hours postoperatively) and ward group (ambulation approximately 6 hours postoperatively). Two groups received standardized postoperative education and were instructed to wear a lumbar brace for 3 weeks. The 12-month follow-up were completed. The postoperative ambulation time, postoperative hospital stay, recurrence rate, visual analogue scale (VAS), Oswestry disability index scor, MacNab score and patient satisfaction were compared between two groups.

Results A total of 395 patients completed the final follow-up, including 200 cases in the day surgery group and 195 cases in the ward group. The VAS and ODI scores in two groups on the first day after surgery and at the last follow-up were significantly improved compared with those before surgery (P ＜ 0.01). At the last follow-up, the excellent and good rate of modified MacNab was 95.00% in the day group and 93.85% in the ward group, and there was no statistical significance between two groups (P ＞ 0.05). The overall recurrence rate was 3.29%, with a recurrence rate of 3.5% (7 cases) in the day surgery group and 3.08% (6 cases) in the ward group. There was no statistically significant difference in the recurrence rate between two groups (P ＞ 0.05). One case of intraoperative dural tear occurred in each of the two groups, and there were no other serious complications. The time of first getting out of bed after surgery, length of hospital stay and the time for young patients to return to work in the day surgery group were significantly earlier/shorter than those in ward group, and the recommendation rate of patients was higher.

Conclusions The day surgery mode for treating lumbar disc herniation with full-endoscopic spinal surgery is safe and feasible. Early ambulation does not exert a significant negative impact on patients' prognosis or recurrence rate. The standardized perioperative health education is the key to ensuring the prognosis of day surgery. This mode can shorten the length of hospital stay, promote patients' early return to work, and thus has clinical promotion value.