单侧双通道内镜治疗多节段退变性腰椎疾病(开放获取)
作者:
作者单位:

首都医科大学附属北京朝阳医院骨科,北京 100020

作者简介:

李冬月,副主任医师,研究方向:脊柱外科,(电子信箱)pku_ldy@126.com

中图分类号:

R681.57


Unilateral biportal endoscopy for the treatment of multilevel degenerative lumbar disease
Author:
Affiliation:

Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020 , China

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    摘要:

    [目的] 探讨单侧双通道脊柱内镜技术(unilateral biportal endoscopy, UBE) 治疗多节段退变性腰椎疾病(multileveldegenerative lumbar disease, MDLD) 的安全性和临床疗效。[方法] 回顾性分析2020 年7 月—2022 年6 月本科收治的29 例MDLD 患者的临床资料,均采用UBE 技术治疗。评价临床及影像结果。[结果] 29 例患者均顺利完成手术,手术时间平均(178.6±26.5) min,术中透视次数平均(10.9±2.9) 次。并发症方面,硬膜囊撕裂2 例,短暂性下肢麻木2 例,硬膜外血肿1 例,均未引起严重不良后果。随访时间平均(19.3±6.3) 个月,随术前、术后7 d、术后3 个月至术后12 个月的时间推移,VAS 评分[(6.6±1.5), (3.2±0.5), (2.1±0.6), (1.7±0.5), P<0.001]、ODI 评分[(58.6±11.2), (33.5±4.6), (22.8±3.8), (17.5±2.2), P<0.001]、JOA 评分[(15.6±2.4), (19.6±2.0), (21.2±2.2), (24.7±2.5), P<0.001] 均显著改善。术后12 个月,按改良MacNab 疗效评定标准,优良率86.2%。影像方面,与术前相比,术后12 个月椎管面积显著增加[(58.3±9.6) mm2, (118.4±14.2) mm2, P<0.001]。术后各节段关节突关节面积保留率均超过60%。[结论] UBE 技术治疗MDLD 的临床效果满意,保留更多小关节突,有利于维持腰椎的稳定性,是一种安全有效的术式。

    Abstract:

    [Objective] To explore the safety and clinical efficacy of unilateral biportal endoscopy (UBE) in the treatment of multileveldegenerative lumbar disease ( MDLD). [Methods] Twenty nine patients who received surgical decompression with UBE for MDLD from July2020 to June 2022 were retrospectively analyzed. The clinical and imaging data were evaluated. [Results] All the 29 patients successfullycompleted the operation, with the average operation time of (178.6±26.5) min, the average intraoperative fluoroscopy times of (10.9±2.9). Interm of complication, dural tear happened in 2 cases, transient lower limb numbness in 2 cases, and epidural hematoma in 1 case, which notled serious consequence in anyone of them. The follow-up period lasted for (19.3±6.3) months in average. As time went from the point beforesurgery, to 7 days, 3 months and 12 months postoperatively, the VAS score for pain [(6.6±1.5), (3.2±0.5), (2.1±0.6), (1.7±0.5), P<0.001], ODIscore [(58.6±11.2), (33.5±4.6), (22.8±3.8), (17.5±2.2), P<0.001], JOA score [(15.6±2.4), (19.6±2.0), (21.2±2.2), (24.7±2.5), P<0.001] signifi-cantly improved. At 12 months after operation, the excellent and good rate was of 86.2%, according to the modified MacNab criteria. In termsof imaging, there was a significant increase in spinal canal area at 12 months after surgery compared with that preoperatively [(58.3±9.6)mm2, (118.4±14.2) mm2, P<0.001]. The retention rate of facet joints was more than 60% in all levels. [Conclusion] The UBE used in thetreatment of MDLD does achieve satisfactory clinical outcomes, with a benefit to maintain the stability of lumbar spine by preserving morefacet joints, is a safe and effective operation.

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李冬月,苏庆军,张希诺,等. 单侧双通道内镜治疗多节段退变性腰椎疾病(开放获取)[J]. 中国矫形外科杂志, 2024, 32 (19): 1807-1810. DOI:10.20184/j. cnki. Issn1005-8478.100459.
LI Dong- yue, SU Qing- jun, ZHANG Xi- nuo, et al. Unilateral biportal endoscopy for the treatment of multilevel degenerative lumbar disease[J]. Orthopedic Journal of China , 2024, 32 (19): 1807-1810. DOI:10.20184/j. cnki. Issn1005-8478.100459.

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  • 在线发布日期: October 09,2024