单侧双通道内镜与椎间孔镜治疗腰椎管狭窄症的近期疗效比较  

Comparative Study of Short-term Clinical Efficacy of Unilateral Biportal Endoscopy and Percutaneous Endoscopic Lumbar Discectomy for Unilateral Symptomatic Lumbar Spinal Stenosis

作　　者：许世东 张景贺 邢建强[1] 田霖 窦永峰[1] Xu Shidong;Zhang Jinghe;Xing Jianqiang(Department of Spine Surgery,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院脊柱外科,滨州256603

出　　处：《中国微创外科杂志》2022年第9期712-716,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的比较单侧双通道内镜(unilateral biportal endoscopy,UBE)和经皮椎间孔镜(percutaneous endoscopic lumbar discectomy,PELD)治疗单侧症状腰椎管狭窄症的近期疗效。方法回顾性分析2019年10月~2020年10月共98例单侧症状腰椎管狭窄症资料,按患者意愿,其中57例选择局麻下PELD,41例选择全麻下UBE。比较2组手术时间、术后并发症、术后卧床时间,术前及术后1天、1个月、12个月疼痛视觉模拟评分(Visual Analogue Scale,VAS),术前及术后1个月、12个月Oswestry功能障碍指数(Oswestry Disability Index,ODI),术后1年以改良MacNab标准评价疗效。结果2组均顺利完成手术,2组手术时间差异无统计学意义(P>0.05)。PELD组术后卧床时间更短[(0.2±0.3)h vs.(6.3±0.4)h,t=-86.819,P=0.000],下肢深静脉血栓形成(deep vein thrombosis,DVT)发生率更低[1.8%(1/57)vs.14.6%(6/41),χ^(2)=4.181,P=0.041]。2组术后VAS评分和ODI均较术前显著改善(P<0.05),2组间差异无统计学意义(P>0.05)。2组术后12个月优良率差异无统计学意义[97.6%(40/41)vs.98.2%(56/57),P=1.000]。结论UBE和PELD均为治疗单侧症状腰椎管狭窄症的有效手术方式,PELD并发症更少。Objective To compare the short-term clinical efficacy of unilateral biportal endoscopy(UBE)and percutaneous endoscopic lumbar discectomy(PELD)for the treatment of unilateral symptomatic lumbar spinal stenosis.Methods We retrospectively analyzed 98 cases of unilateral symptomatic lumbar spinal stenosis from October 2019 to October 2020.According to the wishes of patients,PELD was performed in 57 cases under local anesthesia and UBE was applied in 41 cases under general anesthesia.The operation time,postoperative complications,and postoperative bed rest time were compared.The Visual Analogue Scale(VAS)score and the Oswestry Disability Index(ODI)before operation,and one day,one month and 12 months after operation were compared.The curative effect was evaluated by the modified MacNab criteria one year after operation.Results The operation was successfully completed in both groups.There was no significant difference in operation time(P>0.05).The postoperative bed rest time was shorter in the PELD group than the UBE group[(0.2±0.3)h vs.(6.3±0.4)h,t=-86.819,P=0.000].The incidence of postoperative deep vein thrombosis was lower in the PELD group than the UBE group[1.8%(1/57)vs.14.6%(6/41),χ^(2)=4.181,P=0.041].The VAS scores and ODI after operation were significantly improved in both groups as compared with those before operation(P<0.05),without significant difference between the two groups(P>0.05).There was no significant difference in the excellent and good rate between the two groups 12 months after operation[97.6%(40/41)vs.98.2%(56/57),P=1.000].Conclusion Both UBE and PELD are effective surgical methods for the treatment of unilateral symptomatic lumbar spinal stenosis,and PELD has fewer complications.

关 键 词：经皮椎间孔镜 腰椎管狭窄症 单侧双通道内镜 

分 类 号：R687.3[医药卫生—骨科学]