单侧双通道内镜治疗重度游离型腰椎间盘脱出△

Unilateral biportal endoscopy for severe sequestered lumbar disc herniation

摘要:

[目的] 探讨单侧双通道脊柱内镜技术 （unilateral biportal endoscopy, UBE） 治疗重度游离型腰椎间盘突出症的短期疗效。[方法]回顾分析本院 2020 年 6 月—2021 年 6 月采用 UBE 技术治疗重度游离型腰椎间盘突出症 30 例患者的临床资料。 其中男 17 例，女 13 例，平均年龄（53.5±12.6）岁。观察临床及实验室检查结果。[结果]所有患者均顺利完成手术，无严重术中并发症，手术时间平均（93.6±17.1）min，住院时间平均（3.8±1.1）d。随时间推移，VAS、ODI 评分显著减少（P＜0.05），JOA 评分显著增加（P＜0.05）。随访 60 d 时，按照改良 MacNab 标准评估优良率为 96.7%。实验室检查方面，与术前相比，术后第 1 d，CRP、ESR、CPK 均显著升高（P＜0.05），但在术后第 3 d 时均已降至术前水平，在正常生理范围内。[结论]UBE 技术可非常有效治疗重度游离型腰椎间盘突出症，短期疗效显著。

Abstract:

[Objective] To evaluate the short-term efficacy of unilateral biportal endoscopy (UBE) for severe sequestered lumbar disc herniation. [Methods] A retrospective study was done on 30 patients who underwent UBE for severe sequestered lumbar disc herniation in our hospital from June 2020 to June 2021. The clinical consequences and laboratory tests were assessed. [Results] All patients had operation performed smoothly with on serious intraoperative complications, while with operative time of (93.6±17.1) min and hospital stay of (3.8±1.1) days. The VAS and ODI scores significantly decreased (P＜0.05), while JOA scores significantly increased over time (P＜0.001). At 60 days postoperatively, the overall excellent rate was of 96.7% according to modified MacNab criteria. In term of laboratory test, the CRP, ESR, and CPK significantly upgraded 1 day postoperatively compared with those preoperatively (P＜0.05), whereas which declined 3 days postopera- tively to the normal levels. [Conclusion] The UBE technique is highly effective treatment for severe sequestered lumbar disc herniation with satisfactory short-term outcomes.