单侧双通道内镜椎间盘切除术的初步结果△

Preliminary outcomes of unilateral biportal endoscopic discectomy

摘要:

[目的] 探讨单侧双通道内镜技术治疗腰椎间盘突出症的疗效和安全性。[方法] 2020 年 1 月—2020 年 8 月，作者采用 UBE 技术治疗腰椎间盘突出症 36 例，其中，男 23 例，女 13 例；平均年龄 (39.30±13.90) 岁，病变节段位于 L3/4 1 例， L4/5 18 例，L5S1 17 例。评价临床与影像结果。[结果]所有患者顺利完成手术，平均手术时间(89.19±35.20)min，术后引流量 (19.25±15.90)ml，住院时间(3.53±2.14)d。除 1 例患者术中神经根损伤，但未引起严重不良后果外，其余患者均无术中并发症。随访时间(4.30±1.23)个月，术后 VAS 评分、Oswestry 指数均较术前显著改善(P＜0.05)。按改良 Macnab 标准，临床结果优良率为 91.67%。影像方面，末次随访 MRI 显示椎间隙高度较术前显著降低(P＜0.05)，椎管面积较术前显著增加(P＜0.05)。[结论]单侧双通道技术具有相对易于掌握的优点，是治疗腰椎间盘突出症的安全可行方法。

Abstract:

[Objective] To exlpore the efficacy and safety of unilateral biportal endoscopy (UBE) in the treatment of lumbar disc hernia- tion. [Methods] From January 2020 to August 2020, 36 patients, including 23 males and 13 females aged (39.30±13.90) years on a mean, were treated by UBE technique for lumbar disc herniation involving L3/4 in a case, L4/5 in 18 cases and L5S1 in 17 cases. The clinical and im- aging consequences were evaluated. [Results] All patients had UBE discectomy completed successfully with operation time of (89.19±35.20) min, postoperative drainage volume of (19.25±15.90) ml, and hospital stay of (3.53±2.14) days. All the patients had no serious intraoperative complications, except one patient who got nerve root injury that not lead serious consequence. As time went during the follow up period last- ed for (4.30±1.23) months, the low back pain and leg pain VAS scores, as well as Oswestry index significantly improved (P<0.05) . According to the modified Macnab’s criteria, the excellent and good rate of clinical results was of 91.67%. Radiographically, a significant decrease of the intervertebral height, whereas a significant enlargement of spinal canal area was found at the latest follow up compared with those preop- eratively (P<0.05) . [Conclusion] The UBE technique has a character of relatively easy to be mastered, is a safe and feasible method for the treatment of lumbar disc herniation.