单侧双通道内镜腰椎间盘切除纤维环修复△

Unilateral biportal endoscopic lumbar discectomy and annulus fibrosus suture for huge lumbar disc prolapse

摘要:

［目的］ 探讨单侧双通道脊柱内镜 （unilateral biportal endoscopy, UBE） 椎间盘切除和纤维环修复术治疗巨大突出型腰椎间盘突出症的临床效果。［方法］回顾性分析 2019 年 9 月—2021 年 9 月采用 UBE 椎间盘切除纤维环缝合治疗巨大突出型腰椎间盘突出症的 31 例患者的临床资料。评价围手术期、随访和影像资料。［结果］所有患者均顺利完成手术，随访（13.74± 5.23）个月。随时间推移，患者 VAS 及 ODI 评分均显著减少（P<0.05），而 JOA 评分显著增加（P<0.05）。末次随访时，按改良 MacNab 标准，优 23 例，良 5 例，可 3 例；优良率为 90.32%。影像方面，与术前相比，患者术后 3 个月及末次随访时椎管面积显著增加（P<0.05）；椎间隙高度有所下降，但差异无统计学意义（P>0.05）；Pfirrmann 分级显著改善（P<0.05）。［结论］UBE 椎间盘切除纤维环修复术可有效治疗巨大突出型椎间盘突出，临床效果满意。

Abstract:

[Objective] To investigate the clinical efficiency of unilateral biportal endoscopic (UBE) discectomy and annulus fibrosus su- ture for huge lumbar disc prolapse. [Methods] A retrospective study was performed on 31 patients who received UBE and annulus fibrosus suture for huge lumbar disc prolapse from September 2019 to September 2021. The perioperative period, follow-up and imaging data were evaluated. [Results] All the patients had operations performed successfully, and followed up for (13.74±5.23) months on an average. The VAS and ODI scores decreased significantly (P<0.05) , while the JOA score significantly increased over time (P<0.05) . At the latest followup, the clinical outcome was graded as excellent in 23 cases, good in 5 cases, fair in 3 cases according to the modified MacNab criteria, with the excellent and good rate of 90.32%. Radiographically, spinal canal area significantly increased (P<0.05) ; the intervertebral space height decreased, but which was not statistically significant (P>0.05) ; the Pfirrmann classification for disc degeneration significantly improved at 3 months postoperatively and latest follow-up compared with those preoperatively (P<0.05) . [Conclusion] The UBE discectomy and annulus fibrosus suture does effectively treat huge lumbar disc prolapse with satisfactory clinical results.