单侧双通道内镜治疗夜间痛性腰椎管狭窄症

Unilateral biportal endoscopy for lumbar spinal stenosis with nocturnal pain

摘要:

[目的] 探讨单侧双通道内镜 （unilateral biportal endoscopic, UBE） 治疗以夜间痛 （night pain, NP） 为主要临床表现的腰椎管狭窄症 （lumbar spinal stenosis, LSS） 的疗效。[方法] 回顾性分析本院 2020 年 9 月—2021 年 12 月行 UBE 治疗的以 NP 为主要表现的 LSS 患者 16 例，比较临床及影像资料。[结果] 16 例患者均顺利完成手术，无严重并发症出现，手术时间 （68.2±7.6） min，总切口长度 （2.5±0.5） cm，下地行走时间 （2.3±0.5） d，住院时间 （6.8±0.9） d。患者平均随访 （10.3±2.2） 个月，与术前相比，出院时及末次随访 VAS 评分 [(5.8±0.4), (3.6±0.5), (1.1±0.7), P＜0.05] 及 ODI 睡眠状况得分 [(3.4±0.5), (2.4± 0.5), (0.3±0.6), P＜0.05] 均显著降低。影像评估上，与术前相比，出院时及末次随访椎管矢状径 [(9.9±0.5) mm, (17.6±1.2) mm, (17.4±1.2) mm, P＜0.05] 及椎管面积 [(0.9±0.1) cm² , (1.5±0.1) cm² , (1.5±0.1) cm² , P＜0.05] 均显著增大。末次随访时依照改良 MacNab 标准：优 13 例，良 2 例，可 1 例，优良率 93.8%。[结论]对于以 NP 为主要表现的 LSS 患者，UBE 可有效缓解疼痛症状，改善睡眠状况。

Abstract:

[Objective] To investigate the clincal outcomes of unilateral biportal endoscopy (UBE) for lumbar spinal stenosis (LSS) with nocturnal pain (NP) as the main clinical manifestations. [Methods] A retrospective study was performed on 16 patients who received UBE for LSS with NP as the main manifestation in our hospital from September 2020 to December 2021. The clinical and imaging documents were evaluated. [Results] All the 16 patients had the UBE procedures performed successfully without serious complications, while with op- eration time of (68.2±7.6) min, total incision length of (2.5±0.5) cm, postoperative walking time of (2.3±0.5) days, and hospital stay of (6.8± 0.9) days. All of them were followed up for an average of (10.3±2.2) months. With time elapsed preoperatively, at dischange and the latest follow-up, theVAS score [(5.8±0.4), (3.6±0.5), (1.1±0.7), P＜0.05] and the ODI sleep score [(3.4±0.5), (2.4±0.5), (0.3±0.6), P＜0.05] signifi- cantly decreased. Radiographically, vertebral canal sagittal diameter [(9.9±0.5) mm, (17.6±1.2) mm, (17.4±1.2) mm, P＜0.05] and vertebral canal area [(0.9±0.1) cm² , (1.5±0.1) cm² , (1.5±0.1) cm² , P＜0.05] significantly increased. At the last follow-up, the consequence was marked as excellent in 13 cases, good in 2 cases and fair in 1 case with excellent and good rate of 93.8% according to the modified MacNab criteria. [Conclusion] This UBE does effectively relieve pain symptoms and improve sleep status for patients who have LSS with NP as the main manifestation.