神经根型颈椎病内镜与开放减压融合的比较△（开放获取）

Unilateral biportal endoscopic decompression versus anterior cervical decompression and fusion for single-segment cervical spondylotic radiculopathy

摘要:

［目的］ 比较单侧双通道脊柱内镜术（unilateral biportal endoscopy, UBE） 与开放颈前路减压植骨融合术（anterior cer-

vical decompression and fusion, ACDF） 治疗单节段神经根型颈椎病（cervical spondylotic radiculopathy, CSR） 的临床疗效。［方

法］ 回顾性分析2021 年1 月—2023 年6 月本科手术治疗单节段CSR 的28 例患者的临床资料。依据术前医患沟通结果，12 例

接受UBE，另外16 例接受ACDF，比较两组围手术期资料、随访及影像学资料。［结果］ 两组患者均顺利完成手术，UBE 组切

口长度[(1.9±0.1) cm vs (5.5±0.6) cm, P<0.001]、术中失血量[(22.1±5.0) mL vs (35.9±12.6) mL, P<0.001] 及住院天数[(6.3±1.8) d vs

(9.3±3.1) d, P=0.003] 均显著优于ACDF 组，但前者术中透视次数显著多于后者[(5.3±0.8) 次vs (3.4±0.8) 次, P<0.001]。两组患者随

访时间均超过12 个月，两组恢复完全负重活动时间的差异无统计学意义（P>0.05）。与术前相比，两组患者术后3 个月及末次随

访时VAS、NDI、JOA 评分均显著改善（P<0.05）。同一时间点，两组间的上述评分的差异均无统计学意义（P>0.05）。影像方

面，末次随访时，UBE 组的椎间孔面积[(67.0±3.2) mm² vs (61.2±3.6) mm², P<0.001]、颈椎前凸角[(20.4±0.9) ° vs (17.7±1.5) °, P<

0.001] 均显著优于ACDF 组，但前者的椎间隙高度明显不及后者[(5.4±0.6) mm vs (6.0±0.7) mm, P=0.025]。［结论］ UBE 在治疗单节

段CSR 上与ACDF 疗效相当，但内镜手术组织损伤更少，且术后恢复更快。

Abstract:

[Objective] To compare clinical consequences of unilateral biportal endoscopy (UBE) versus anterior cervical decompres-

sion and fusion (ACDF) in the treatment of single-level cervical spondylotic radiculopathy (CSR). [Methods] A retrospective research was

performed on 28 patients who had single-segment CSR treated surgically from January 2021 to June 2023. According to the preoperative

doctor-patient communication, 12 patients received UBE, while other16 patients received ACDF. The perioperative, follow-up and imaging

data of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed smoothly. The

UBE group proved significantly superior to the ACDF group in terms of incision length [(1.9±0.1) cm vs (5.5±0.6) cm, P<0.001], intraopera-

tive blood loss [(22.1±5.0) mL vs (35.9±12.6) mL, P<0.001] and hospital stay [(6.3±1.8) days vs (9.3±3.1) days, P=0.003], despite of that the

former consumed significantly more intraoperative fluoroscopy times than the latter [(5.3±0.8) times vs (3.4±0.8) times, P<0.001]. The fol-

low-up period was lasted for more than 12 months, and there was no significant difference in time to regain full weight-bearing activities be-

tween the two groups (P>0.05). The VAS, NDI and JOA scores in both groups were significantly improved 3 months after surgery and at the

last follow-up compared with those preoperatively (P<0.05), whereas which were not statistically significant between the two groups at any

time points accordingly (P>0.05). Radiographically, the UBE group proved significantly better than the ACDF group in terms of foramen ar-

ea [(67.0±3.2) mm² vs (61.2±3.6) mm^2, P<0.001] and the cervical lordotic angle [(20.4±0.9)° vs (17.7±1.5)°, P<0.001], whereas the former

had significantly less intervertebral height than the latter at the latest follow-up [(5.4±0.6) mm vs (6.0±0.7) mm, P=0.025]. [Conclusion]

The UBE does achieve satisfactory clinical outcome comparable with the ACDF in the treatment of single-segment CSR. The former takes

advantages of less tissue injury and faster postoperative recovery over the latter.

Abstract:

[Objective] To compare clinical consequences of unilateral biportal endoscopy (UBE) versus anterior cervical decompres-

sion and fusion (ACDF) in the treatment of single-level cervical spondylotic radiculopathy (CSR). [Methods] A retrospective research was

performed on 28 patients who had single-segment CSR treated surgically from January 2021 to June 2023. According to the preoperative

doctor-patient communication, 12 patients received UBE, while other16 patients received ACDF. The perioperative, follow-up and imaging

data of the two groups were compared. [Results] All patients in both groups had corresponding surgical procedures performed smoothly. The

UBE group proved significantly superior to the ACDF group in terms of incision length [(1.9±0.1) cm vs (5.5±0.6) cm, P<0.001], intraopera-

tive blood loss [(22.1±5.0) mL vs (35.9±12.6) mL, P<0.001] and hospital stay [(6.3±1.8) days vs (9.3±3.1) days, P=0.003], despite of that the

former consumed significantly more intraoperative fluoroscopy times than the latter [(5.3±0.8) times vs (3.4±0.8) times, P<0.001]. The fol-

low-up period was lasted for more than 12 months, and there was no significant difference in time to regain full weight-bearing activities be-

tween the two groups (P>0.05). The VAS, NDI and JOA scores in both groups were significantly improved 3 months after surgery and at the

last follow-up compared with those preoperatively (P<0.05), whereas which were not statistically significant between the two groups at any

time points accordingly (P>0.05). Radiographically, the UBE group proved significantly better than the ACDF group in terms of foramen ar-

ea [(67.0±3.2) mm² vs (61.2±3.6) mm^2, P<0.001] and the cervical lordotic angle [(20.4±0.9)° vs (17.7±1.5)°, P<0.001], whereas the former

had significantly less intervertebral height than the latter at the latest follow-up [(5.4±0.6) mm vs (6.0±0.7) mm, P=0.025]. [Conclusion]

The UBE does achieve satisfactory clinical outcome comparable with the ACDF in the treatment of single-segment CSR. The former takes

advantages of less tissue injury and faster postoperative recovery over the latter.