Objective To compare the efficacy of TESSYS with fenestration in the treatment of lumbar disc herniation with or without lumbar nerve root canal stenosis.Methods The clinical data of patients with lumbar disc herniation with or without lumbar nerve root canal stenosis treated in our hospital from 2017 to 2018 were retrospectively analyzed. There were 34 cases in TESSYS group treated with percutaneous transforaminal TESSYS and 30 cases in open group treated with fenestration of lamina. After 12 months follow-up, the operation time, bleeding volume, hospital stay and complications were observed. VAS score, ODI score and improved MacNa were used to evaluate the clinical efficacy. Independent sample t was used to evaluate the clinical efficacy. Check the data of comparative analysis.Results The VAS scores of the two groups after operationwere lower than those of before (P < 0.05). The VAS scores of the TESSYS group in 3months after operation were significantly lower than open group (P < 0.05). The ODI scores of the two groups after treatment were significantly lower than those ofbefore (P < 0.05). The ODI scores ofTESSYS group in 24hafter operation were significantly lower than open group (P < 0.05). There was no significant difference between the two groups in 3, 6 and 12 months after the operation (P> 0.05). TESSYS group was lower than the development group in operation time, bleeding volume and hospitalization time after operation, the difference was statistically significant (P < 0.05), the incidence of complications was no difference; the excellent and good rate of MacNab in TESSYS group was 94.12%, higher than that in open group 83.33%, there was no significant difference between the two groups (P > 0.05).Conclusion Both percutaneous transforaminal TESSYS and fenestration discectomy can effectively treat lumbar disc herniation, but TESSYS can recover faster in a short time after operation. It is recommended to use TESSYS.