摘要
目的探讨单侧双通道内窥镜下经椎间孔入路腰椎椎间融合术(UBE-TLIF)和微创经椎间孔入路腰椎椎间融合术(MIS-TLIF)治疗Ⅰ、Ⅱ度单节段腰椎滑脱症的临床疗效。方法2019年12月—2021年12月收治单节段腰椎滑脱症患者101例,其中56例采用UBE-TLIF治疗(UBE-TLIF组),45例采用MIS-TLIF治疗(MIS-TLIF组)。记录2组手术时间、术中出血量、住院时间及并发症发生情况。术前、术后1周、术后3个月及末次随访时采用疼痛视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)评价疼痛程度和功能状态;末次随访时记录融合等级、滑脱复位率,采用改良MacNab标准评价临床疗效。结果所有手术顺利完成,所有患者随访时间超过2年。UBE-TLIF组住院时间及术中出血量优于MIS-TLIF组,手术时间长于MIS-TLIF组,差异均有统计学意义(P<0.05)。2组患者术后腰腿痛VAS评分及ODI较术前显著改善,UBE-TLIF组术后1周VAS评分及ODI优于MIS-TLIF组,差异均有统计学意义(P<0.05)。末次随访时2组融合等级、滑脱复位率、疗效优良率差异均无统计学意义(P>0.05)。结论UBE-TLIF和MIS-TLIF治疗Ⅰ、Ⅱ度单节段腰椎滑脱症安全、有效,均可获得满意的临床疗效。相较于MIS-TLIF,UBE-TLIF在手术过程中对组织的损伤较小,患者术后恢复速度更快。
Objective To investigate the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF)and minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)in the treatment of gradeⅠandⅡsingle-segment lumbar spondylolisthesis.Methods From December 2019 to December 2021,101 patients with single-segment lumbar spondylolisthesis were treated,of which 56 were treated with UBE-TLIF(UBE-TLIF group)and 45 with MIS-TLIF(MIS-TLIF group).The operation time,intraoperative blood loss,hospital stay and complications were recorded.At pre-operation,postoperative 1 week,postoperative 3 months and the final follow-up,the pain intensity and functional status were evaluated by visual analogue scale(VAS)score and Oswestry disability index(ODI).At the final follow-up,the fusion grade and slippage reduction rate were recorded,and the clinical efficacy was evaluated using the modified MacNab criteria.Results All the operations were successfully completed,and all the patients were followed up for more than 2 years.The hospital stay and intraoperative blood loss of the UBE-TLIF group were better than those of the MIS-TLIF group,and the operation time was longer than that of the MIS-TLIF group,all with a statistical significance(P<0.05).The VAS scores of low back and leg pain and ODI at each time point after operation in the 2 groups were significantly improved compared with those at pre-operation;at postoperative 1 week,the UBE-TLIF group had better VAS scores of low back and leg pain and ODI than the MIS-TLIF group;and the differences were statistically significant(P<0.05).At the final follow-up,there was no statistically significant difference in the fusion grade,slippage reduction rate,and excellent and good rate of clinical efficacy between the 2 groups(P>0.05).Conclusions UBE-TLIF and MIS-TLIF are safe and effective treatments for gradeⅠandⅡsingle-segment lumbar spondylolisthesis,and both can achieve satisfactory clinical outcomes.Compared to MIS-TLIF,UBE-TLIF causes less tissue damage during surgery,and results in faster postoperative recovery for patients.
作者
唐骞
汤忠鑫
牛旺
刘洋
简磊
申明奎
杨贺军
Tang Qian;Tang Zhongxin;Niu Wang;Liu Yang;Jian Lei;Shen Mingkui;Yang Hejun(Department of Mini-invasive Spinal Surgery,Third People’s Hospital of Henan Province,Zhengzhou 450000,Henan,China)
出处
《脊柱外科杂志》
2025年第4期239-244,共6页
Journal of Spinal Surgery
关键词
腰椎
脊椎滑脱
脊柱融合术
外科手术
微创性
Lumbar vertebrae
Spondylolysis
Spine fusion
Surgical procedures,minimally invasive
