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。
[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.
作者
梁威
孙韶东
李国钰
卓瑞立
冯纪川
LIANG Wei;SUN Shao-dong;LI Guo-yu;ZHUO Rui-li;FENG Ji-chuan(Department of Spine Surgery,General Hospital of Puyang Oil-field,Puyang,Henan 457001,China)
出处
《中国矫形外科杂志》
北大核心
2025年第5期410-415,共6页
Orthopedic Journal of China
基金
河南省二〇二四年科技发展计划项目(编号:242102310489)。
关键词
腰椎椎管狭窄症
Delta内镜
单侧双通道内镜
腰椎管减压
lumbar spinal stenosis
Delta endoscopy
unilateral biportal endoscopy
lumbar spinal canal decompression
