单侧双通道内镜腰椎融合治疗腰椎退行性疾病

Unilateral biportal endoscopic lumbar interbody fusion for lumbar degenerative diseases

摘要:

[目的] 评估单侧双通道内镜腰椎融合（unilateral biportal endoscopiy lumbar interbody fusion, UBE-LIF） 治疗腰椎退行性疾病的疗效。[方法] 回顾性分析2019 年—2022 年在本院接受UBE-LIF 治疗的单节段腰椎退行性疾病患者的临床资料。评价临床及影像结果。[结果] 413 例患者均顺利手术，手术时间平均（158.3±17.2） min，术中出血量平均（217.5±22.1） ml，随访时间平均（17.3±3.1） 个月。与术前相比，术后6 个月及末次随访时，腰痛VAS [(6.9±0.6), (1.6±0.3), (1.4±0.2), P＜0.001]、腿痛VAS [(8.0±0.7), (1.5±0.5), (1.3±0.4), P＜0.001] 及ODI 评分[(78.5±6.1), (17.5±3.7), (17.5±3.7), P＜0.001] 均显著减少。影像方面，与术前相比，术后6 个月及末次随访时，椎管面积[(128.6±19.8) mm², (238.2±12.5) mm², (223.4±12.7) mm², P＜0.001] 、侧隐窝矢状径[(1.5±0.5) mm, (6.3±0.5) mm, (6.0±0.5) mm, P＜0.001] 及椎间隙高度[(7.5±0.7) mm, (12.3±0.5) mm, (11.8±0.5) mm, P＜0.001] 均显著改善。术后第6 个月CT 示融合率达92.5%，末次随访时MacNab 优良率达94.4%。术后并发症发生率为4.6%。[结论] UBE-LIF技术手术时间较长，但总体上临床效果较好，术后并发症率较低。

Abstract:

[Objective] To evaluate the efficacy of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) in the treatmentof degenerative lumbar diseases. [Methods] A retrospective analysis was conducted on 413 patients who had single-segment degenerativelumbar diseases treated by UBE-LIF treatment at our hospital from 2019 to 2022. The clinical and imaging documents were evaluated. [Re-sults] All the patients had UBE-LIF performed successfully with the average operative time of (158.3±17.2) min, the average intraopera-tive blood loss of (217.5±22.1) ml, and were followed up for a mean of (17.3±3.1) months. With time preoperatively, 6 months after surgeryand at the last follow-up, the low back pain VAS [(6.9±0.6), (1.6±0.3), (1.4±0.2), P＜0.001], leg pain VAS [(8.0±0.7), (1.5±0.5), (1.3±0.4),P＜0.001] and ODI scores [(78.5±6.1), (17.5±3.7), (17.5±3.7), P＜0.001] were significantly declined. In term of imaging, the spinal canal ar-ea [(128.6±19.8) mm², (238.2±12.5) mm², (223.4±12.7) mm², P＜0.001], lateral recess sagittal diameter [(1.5±0.5) mm, (6.3±0.5) mm, (6.0±0.5) mm, P＜0.001] and intervertebral height [(7.5±0.7) mm, (12.3±0.5) mm, (11.8±0.5) mm, P＜0.001] were significantly improved over thetime period abovementioned. The CT showed that the fusion rate was 92.5% 6 months after operation, while the MacNab excellent and goodrate of the clinical consequence was of 94.4% at the last follow-up and the postoperative complication rate was of 4.6%. [Conclusion] Al-though the UBE-LIF consumed longer operation time, it achieves good overall clinical outcome, with low postoperative complication.