摘要
目的探讨单侧双通道内镜术(unilateral biportal endoscopic,UBE)治疗腰椎间盘突出症患者的临床疗效及其对腰椎椎旁多裂肌损伤的影响。方法选取2023年6—11月首都医科大学附属北京友谊医院接受UBE治疗的腰椎间盘突出症患者50例,收集其术前、术后3个月及术后6个月腰部和下肢的视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(Oswestry disability index,ODI),采用腰椎MRI测量双侧椎旁多裂肌的脂肪浸润比例和横截面积(cross-sectional area,CSA)进而评估肌肉质量。结果50例患者中,男22例、女28例,年龄31~67岁,平均(48.8±8.4)岁。患者腰部及下肢VAS、ODI在术后3个月[(2.90±0.89)分、(3.24±0.52)分、(11.01±1.88)%]、术后6个月[(1.74±1.12)分、(1.78±0.68)分、(8.18±1.59)%]均较术前[(4.98±0.71)分、(6.98±0.82)分、(56.02±5.48)%]明显下降,差异均有统计学意义(P<0.05)。不同时点、不同手术侧别多裂肌CSA和脂肪浸润比例的比较,差异均无统计学意义(P>0.05)。结论UBE治疗腰椎间盘突出症的临床疗效确切,且对腰椎椎旁多裂肌损伤的影响很小。
Objective To explore the clinical effect of unilateral biportal endoscopic(UBE)in the treatment of lumbar disc herniation and its influence on the injury of paraspinal multifidus.Methods A total of 50 patients with lumbar disc herniation who received UBE treatment in Beijing Friendship Hospital,Capital Medical University from June to November 2023 were selected.The visual analogue scale(VAS)and Oswestry disability index(ODI)of the waist and leg of the patients were collected before,3 months after and 6 months after surgery.The fat infiltration ratio and cross-sectional area(CSA)of bilateral paravertebral multifidus were measured by lumbar MRI,and then the muscle quality was evaluated.Results Among the 50 patients,there were 22 males and 28 females,aged from 31 to 67 years old,with an average of(48.8±8.4)years.The VAS and ODI of the waist and leg decreased significantly at 3 months[(2.90±0.89)score、(3.24±0.52)score、(11.01±1.88)%]and 6 months[(1.74±1.12)score、(1.78±0.68)score、(8.18±1.59)%]after operation lower than those before operation[(4.98±0.71)score、(6.98±0.82)score、(56.02±5.48)%],and the differences were statistically significant(P<0.05).There was no significant difference in the fat infiltration ratio and CSA of bilateral paravertebral multifidus muscle at different time points and different surgical sides(P>0.05).Conclusions UBE is effective in treatment of lumbar disc herniation,and has little effect on the injury of on the lumbar paraspinal multifidus muscles.
作者
张双江
孙海波
冯飞
王开玉
陈浩
Zhang Shuangjiang;Sun Haibo;Feng Fei;Wang Kaiyu;Chen Hao(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《北京医学》
2025年第4期307-310,共4页
Beijing Medical Journal
关键词
单侧双通道内镜术
腰椎间盘突出症
椎旁多裂肌
脂肪浸润比例
横截面积
unilateral biportal endoscopic(UBE)
lumbar disc herniation
paraspinal multifidus muscles
fat infiltration ratio
cross-sectional area(CSA)
