Delta内镜与UBE内镜治疗腰椎椎管狭窄症的比较△

Comparison of Delta endoscopic decompression and unilateral biportal endoscopic counterpart for lumbar spinal stenosis

摘要:

[目的] 比较Delta 内镜与单侧双通道内镜（unilateral biportal endoscopy, UBE） 治疗腰椎管狭窄症（lumbar spinal ste-nosis, LSS） 的疗效。[方法] 回顾性分析2022 年1 月—2023 年6 月内镜减压治疗LSS 100 例患者的临床资料。根据术前医患沟通结果，46 例采用Delta 内镜治疗，54 例采用UBE 内镜治疗。比较围术期、随访及影像结果。[结果] Delta 组在手术时间[(94.2±15.6) min vs (102.3±13.9) min, P=0.007]、切口长度[(1.3±0.1) cm vs (2.2±0.2) cm, P＜0.001] 和术中透视次数[(3.5±0.4) 次vs (6.4±0.6) 次, P＜0.001] 均显著优于UBE 组。两组术中出血量、下床时间、住院时间、切口愈合质量、并发症发生率的差异均无统计学意义（P＞0.05）。与术前相比，两组术后3 个月、末次随访腰、下肢VAS 评分、ODI 指数均逐渐改善，两组差异无统计学意义（P＞0.05），两组完全负重时间差异无统计学意义（P＞0.05）；与术前相比，两组末次随访椎管面积、硬膜囊横截面积均增加（P＜0.05），但两组间的差异无统计学意义（P＞0.05）。[结论] Delta 内镜与UBE 内镜腰椎管减压术治疗LSS 均能获得良好的近期疗效。相比之下，Delta 内镜在手术时间、手术切口长度和透视次数方面优于UBE 内镜。

Abstract:

[Objective] To compare the clinical efficacy of Delta endoscopic decompression versus unilateral biportal endoscopy (UBE)counterpart for lumbar spinal stenosis (LSS). [Methods] A retrospective study was conducted on 100 patients who had LSS treated by endo-scopic decompression from January 2022 to June 2023. According to preoperative doctor-patient communication, 46 patients were treatedwith Delta endoscopic decompression, while other 54 patients received UBE decompression. The perioperative, follow-up and imaging datawere compared between the two groups. [Results] The Delta group proved significantly superior to the UBE grpup im terms of operative time[(94.2±15.6) min vs (102.3±13.9) min, P=0.007], the incision length [(2.2±0.2) cm vs (1.3±0.1) cm, P＜0.001] and intraoperative fluoroscopyfrenquency [(3.5±0.4) times vs (6.4±0.6) times, P＜0.001], although there were no significant differences in intraoperative blood loss, the bedrest time, hospital stay, quality of incision healing and incidence of complications between the two groups (P＞0.05). Compared with those pre-operatively the low back pain and leg pain VAS scores, as well as ODI were gradually improved in both groups 3 months after surgery and atthe last follow-up (P＜0.05), whereas which were not statistically significant between the two groups at any time points accordingly (P＞0.05).In addition, there was no significant difference in the time to regain full weight-bearing activity between the two groups (P＞0.05). As for im-aging evaluation, the vertebral canal area and dural sac cross-sectional area were increased in both groups at the last follow-up comparedwith those preoperatively (P＜0.05), but there was no significant difference between the two groups at any matching time points (P＞0.05).[Conclusion] Both Delta endoscopy and unilateral biportal endoscopy used lumbar canal decompression do achieve satisfactory clinical con-senquence for lumbar spinal stenosis. In comparison, the Delta endoscopy is superior to the UBE in terms of operation time, surgical incisionand fluoroscopy times.