摘要
目的比较单侧双通道内镜下单侧椎板入路双侧减压技术(UBE-ULBD)与开放单侧椎板入路双侧减压手术(ULBD)在腰椎管狭窄症治疗中的疗效。方法回顾性分析2021年6月—2024年3月本院收治的80例腰椎管狭窄症患者的临床资料,根据手术方式分为对照组(开放ULBD手术)与观察组(UBE-ULBD手术)两组,每组各40例。比较两组患者在术中估计出血量、术后引流量、切口长度、手术时间、术后下床时间、住院时间、硬膜囊横断面积、腰腿疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI)腰椎功能评分等指标。结果观察组在术中估计出血量、术后引流量、切口长度、术后下床时间及术后硬膜囊横断面积均显著优于对照组,差异具有统计学意义(P<0.001);观察组与对照组在手术时间对比差异无统计学意义(P=0.329)。重复测量方差显示,观察组术后1个月腰腿痛VAS低于对照组0.07分(95%CI:0.067~0.078),差异具有统计学意义(P<0.001);观察组术后6个月腰腿痛VAS低于对照组0.21分(95%CI:0.18~0.23),差异具有统计学意义(P<0.001);术后1年两组腰腿痛VAS差异无统计学意义(P=0.067)。观察组术后1个月ODI评分低于对照组7.35%(95%CI:3.92~10.78),差异具有统计学意义(P<0.001);术后6个月及术后1年ODI评分两组差异无统计学意义(P=0.198,P=0.362)。术后半年改良的Macnab疗效评定,对照组优良率为90%,观察组优良率为95%,两组差异无统计学意义(P=0.914)。结论UBE-ULBD可以取得与开放ULBD近似的临床疗效,但UBE-ULBD具有更小的创伤及更好的近期效果,值得临床推广应用。
Objective To compare the efficacy of unilateral biportal endoscopic unilateral laminotomy for bilateral decompression(UBE-ULBD)with open unilateral laminotomy for bilateral decompression(ULBD)in the treatment of lumbar spinal stenosis.Methods A retrospective analysis was conducted on the clinical data of 80 patients with lumbar spinal stenosis treated at Yanqi Hospital of the Second Division of Xinjiang Production and Construction Corps from June 2021 to March 2024.Patients were divided into a control group(open ULBD)and an observation group(UBE-ULBD),with 40 patients in each group.Comparisons were made between the two groups regarding intraoperative estimated blood loss,postoperative drainage,incision length,operation time,time to ambulation,hospital stay,dural sac cross-sectional area,visual analog scale(VAS)scores for low back and leg pain,and Oswestry Disability Index(ODI)scores.Results The observation group showed significantly better results in intraoperative estimated blood loss,postoperative drainage,incision length,time to ambulation,and dural sac cross-sectional area compared to the control group,with statistically significant differences(P<0.001).There was no significant difference in operation time between the two groups(P=0.329).Repeated measures ANOVA revealed that the observation group had lower VAS scores for low back and leg pain at 1 month postoperative(0.07 points lower,95%CI:0.067-0.078)and at 6 months postoperative(0.21 points lower,95%CI:0.18-0.23)compared to the control group,with statistically significant differences(P<0.001).There was no significant difference in VAS scores between the two groups at 1 year postoperative(P=0.067).The ODI scores at 1 month postoperative were 7.35%lower in the observation group compared to the control group(95%CI:3.92-10.78),with a statistically significant difference(P<0.001).There were no significant differences in ODI scores at 6 months and 1 year postoperative(P=0.198,P=0.362).The modified Macnab criteria at 6 months postoperative showed excellent and good rates was 90%in the control group and 95%in the observation group,with no significant difference between the two groups(P=0.914).Conclusions UBE-ULBD can achieve similar clinical efficacy to open ULBD,but with less trauma and better short-term outcomes,making it worthy of clinical promotion and application.
作者
徐邦龙
陈屹泉
王和平
樊龙
马景冬
黄厚福
徐乐
杨雄博
Xu Banglong;Chen Yiquan;Wang Heping;Fan Long;Ma Jingdong;Huang Houfu;Xu Le;Yang Xiongbo(Department of Orthopedics,Yanqi Hospital of the Second Division of Xinjiang Production and Construction Corps,Korla,Xinjiang 861000,China)
出处
《齐齐哈尔医学院学报》
2025年第16期1565-1569,共5页
Journal of Qiqihar Medical University
关键词
腰椎管狭窄
单侧双通道
内镜
单侧椎板切开双侧减压
脊柱微创
Lumbar spinal stenosis
Unilateral biportal endoscopy
Endoscopy
Unilateral laminotomy for bilateral decompression
Minimally invasive spine surgery
