摘要
[目的]比较单侧双通道内镜(unilateral biportal endoscopy,UBE)和椎间孔镜(percutaneous endoscopic transforaminal discectomy,PETD)治疗腰椎间盘突出症的临床疗效。[方法]回顾性分析2019年2月—2020年9月采用内镜椎间盘切除术治疗的67例腰椎间盘突出症患者的临床资料,根据医患沟通结果,28例采用UBE组术,另外39例采用PETD术,比较两组围手术期、随访及影像结果。[结果]所有患者均顺利完成手术,UBE组手术时间[(58.1±10.6)min vs(65.5±11.3)min,P=0.009]、术中透视次数[(3.1±1.1)次vs(5.2±1.2)次,P<0.001]显著少于PETD组,但前切口长度[(2.3±0.2)cm vs(1.2±0.2)cm,P<0.001]和椎间盘切除量[(3.5±1.1)cm^(3)vs(2.8±1.1)cm^(3),P=0.011]显著大于后者。随访时间平均(10.5±2.0)个月。两组完全负重活动时间的差异无统计学意义(P>0.05)。随时间推移,两组VAS及ODI评分均显著改善(P<0.05)。术后1个月UBE组的腰痛VAS[(2.3±0.7)vs(2.7±0.6),P=0.028]及ODI[(27.1±4.9)vs(29.7±5.3),P=0.045]显著优于PETD组。影像方面,两组患者术后神经根压迫Pfirrmann分级均显著改善(P<0.05),椎管横截面积(cross-sectional area of canal,CSAC)显著增加(P<0.05),而椎间孔面积无显著变化(P>0.05)。术后UBE组的CSAC显著优于PETD组[(184.4±40.6)mm^(2)vs(137.0±28.9)mm^(2),P<0.001]。[结论]单侧双通道内镜技术作为一种新的脊柱内镜技术,创伤小,减压充分,有利于患者早期恢复。
[Objective]To compare the clinical consequences of unilateral biportal endoscopy(UBE)versus percutaneous endoscopic transforaminal discectomy(PETD)for lumbar disc herniation.[Methods]A retrospective study was done on 67 patients who received endoscopic discectomy for lumbar disc herniation from February 2019 to September.According to the results of doctor-patient communication,28 patients were treated with UBE,while other 39 cases were with PETD.The perioperative period,follow-up and imaging data of the two groups were compared.[Results]All patients in both groups were successfully operated on.The UBE group proved significantly less than the PETD group in terms of operative time[(58.1±10.6)min vs(65.5±11.3)min,P=0.009]and intraoperative fluoroscopy times[(3.1±1.1)times vs(5.2±1.2)times,P<0.001].However,the former was significantly greater than the latter in terms of incision length[(2.3±0.2)cm vs(1.2±0.2)cm,P<0.001]and the disc volume removed[(3.5±1.1)cm^(3) vs(2.8±1.1)cm^(3),P=0.011].The average follow-up time was(10.5±2.0)months,and there was no significant difference in the time to resume full weight-bearing activities between the two groups(P>0.05).The VAS and ODI scores in both groups were significantly improved over time(P<0.05).The UBE group was significantly superior to the PETD group in terms of the lower back pain VAS[(2.3±0.7)vs(2.7±0.6),P=0.028]and ODI[(27.1±4.9)vs(29.7±5.3),P=0.045]one month postop eratively.As for imaging,the Pfirrmann grade of nerve root compression was significantly improved(P<0.05),and the cross-sectional area of canal(CSAC)was significantly increased(P<0.05),while the CSA of the foraminal area remained unchanged in both groups postoperatively compared with those preoperatively(P>0.05).The UBE group was also better than the PETD group regarding postoperative CSAC[(184.4±40.6)mm^(2) vs(137.0±28.9)mm^(2),P<0.001].[Conclusion]As a new spinal endoscopy technique,unilateral biportal endoscopy has advantages of less trauma and full decompression,is conducive to early rec
作者
李光曦
丁永利
LI Guang-xi;DING Yong-li(The First Affiliated Hospital,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2024年第21期1953-1958,共6页
Orthopedic Journal of China
关键词
腰椎间盘突出症
单侧双通道内镜技术
椎间孔镜
预后
lumbar disc herniation
unilateral biportal endoscopy
percutaneous endoscopic transforaminal discectomy
prognosis
