摘要
目的通过Meta分析比较经椎板间入路单通道脊柱内镜与单侧双通道脊柱内镜手术治疗腰椎间盘突出症的临床疗效。方法检索中国知网、万方数据、维普数据、PubMed、Embase、Conchrane Libray等数据库有关椎板间入路单通道脊柱内镜(PEID组)与单侧双通道脊柱内镜(UBED组)手术治疗腰椎间盘突出症的文献,检索时间自数据库建立之初至2024-12-01,分别由2位研究者单独进行文献质量评价及数据提取,结局指标至少包含手术时间、术中X线透视次数、住院时间、术后腰痛和腿痛VAS评分、末次随访时ODI指数、术后并发症发生率、末次随访时疗效优良率。结果纳入12篇文献,PEID组504例,UBED组401例。PEID组手术时间、住院时间较UBED组短,术后3 d腰痛VAS评分较UBED组低,差异有统计学意义(P<0.05);两组术中X线透视次数、末次随访腰痛VAS评分、术后3 d腿痛VAS评分、末次随访腿痛VAS评分、末次随访时ODI指数、术后并发症发生率及末次随访优良率差异无统计学意义(P>0.05)。结论单通道脊柱内镜和单侧双通道脊柱内镜手术治疗腰椎间盘突出症均有较高的安全性、较低并发症发生率,可以获得满意疗效;单纯髓核摘除时,单通道脊柱内镜手术时间和住院时间更短,而且在术后短期腰痛缓解方面更具优势。
Objective To compare the clinical efficacy of uniportal interlaminar spinal endoscopy versus unilateral biportal endoscopic discectomy for lumbar disc herniation via meta-analysis.Methods Literature published in database from inception to December 1,2024,was retrieved from CNKI,Wanfang Data,VIP Database,PubMed,Embase,and Cochrane Library.Studies comparing uniportal interlaminar endoscopy(PEID group)with unilateral biportal endoscopic discectomy(UBED group)for lumbar disc herniation were included.Two independent researchers conducted quality assessment and data extraction.Outcome measures included:operative time,intraoperative fluoroscopy frequency,hospital stay,postoperative visual analog scale(VAS)scores for low back pain and leg pain,Oswestry Disability Index(ODI)at final follow-up,complication rates,and excellent/good rate at final follow-up.Results Twelve studies involving 504 patients in the PEID group and 401 in the UBED group were included.The PEID group demonstrated significantly shorter operative time(P<0.05),reduced hospital stay(P<0.05),and lower VAS scores for back pain at postoperative day 3(P<0.05)compared to the UBED group.No statistically significant differences were observed in intraoperative fluoroscopy frequency,VAS scores for back/leg pain at final follow-up,ODI at final follow-up,complication rates,or excellent/good rates(P>0.05).Conclusion Both techniques demonstrate high safety profiles with low complication rates and favorable outcomes.For simple discectomy cases,PEID offers advantages in reduced operative time,shorter hospitalization,and superior short-term back pain relief.
作者
顾世勤
张博
朱伟东
张勇鹏
费国策
刘岗
许立新
方毅
GU Shiqin;ZHANG Bo;ZHU Weidong;ZHANG Yongpeng;FEI Guoce;LIU Gang;XU Lixin;FANG Yi(Department of Spinal Surgery,NO.215 Hospital of Shaanxi Nuclear Industry,Xianyang,Shaanxi 712000,China)
出处
《中国骨与关节损伤杂志》
2025年第7期683-687,共5页
Chinese Journal of Bone and Joint Injury
