UBE与PELD治疗退行性腰椎管狭窄症的效果比较  

Comparison of the effectiveness between UBE and PELD in the treatment of degenerative lumbar spinal stenosis

作　　者：谭月坤 劳贵昌[1] 韦振飞 张瀚[1] 梁树威[1] 黄耀晴 曾繁悦 耿齐梓 庞慎宁 苏允裕[1] TAN Yuekun;LAO Guichang;WEI Zhenfei;ZHANG Han;LIANG Shuwei;HUANG Yaoqing;ZENG Fanyue;GENG Qizi;PANG Shenning;SU Yunyu(Department of Spinal Orthopaedics,Qinzhou First People's Hospital,Qinzhou,Guangxi Zhuang Autonomous Region 535000,China)

机构地区：[1]钦州市第一人民医院脊柱骨病外科,广西壮族自治区535000

出　　处：《中国骨科临床与基础研究杂志》2024年第2期115-120,共6页Chinese Journal of Orthopaedic Clinical and Basic Research

基　　金：广西卫生健康委员会科研课题(Z-N20221865)。

摘　　要：目的比较单侧双通道内镜(UBE)和经皮内镜下腰椎间盘切除术(PELD)治疗退行性腰椎管狭窄症(DLSS)的疗效差异。方法回顾性分析2021年10月至2022年6月钦州市第一人民医院收治的74例DLSS患者的临床资料,按手术方式的不同将患者分为UBE组(采用UBE手术,38例)和PELD组(采用PELD,36例)。记录手术时间和围术期并发症,评估患者手术前后腰腿痛视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI),比较两组术后1个月硬膜囊横截面积和术后12个月手术疗效(按改良MacNab标准)的差异。结果两组均顺利完成手术。与PELD组相比,UBE组手术时间更短(P<0.05);两组围手术期并发症发生率及术后12个月随访优良率相近(P>0.05)。患者术后1 d,1、12个月VAS评分和术后1、12个月ODI均较术前改善(P<0.05);组间比较,差异无统计学意义(P>0.05)。术后1个月UBE组硬膜囊横截面积大于PELD组,两组比较,差异有统计学意义(P<0.05)。结论UBE和PELD均为治疗DLSS的有效手术方式,其中UBE手术时间更短,术后硬膜囊横截面积增加值更大,对临床术式选择有一定的指导意义。Objective To compare the differences of curative effects of unilateral biportal endoscopy(UBE)and percutaneous endoscopic lumbar discectomy(PELD)in the treatment of degenerative lumbar spinal stenosis(DLSS).Methods Clinical data of 74 DLSS patients treated from October 2021 to June 2022 in Qinzhou First People's Hospital were retrospectively analyzed.According to different procedures,patients were divided into UBE group(performing UBE surgery,n=38)and PELD group(performing PELD surgery,n=36).Operative time and perioperative complications were recorded,visual analogue scale(VAS)score and Oswestry disability index(ODI)before and after the operation were evaluated,dural sac cross-sectional area(DSCA)at 1 month after surgery and surgical outcome evaluated by modified MacNab criteria at 12 months postoperatively were compared between the two groups.Results The operation was successfully completed in both groups.Compared with the PELD group,the UBE group had shorter operation time(P<0.05).Incidence of perioperative complications as well as excellent and good rate of surgical outcome at 12 months postoperatively were similar in two groups (P > 0.05). VAS score at 1 d, 1 and 12 months postoperatively, as well as ODI at 1 and 12 months after the surgery were all improved compared with preoperative ones (P <0.05), while there was no statistical difference between the two groups at the same timepoint (P >0.05). At 1 month after surgery, DSCA of patients in UBE group were larger than those in PELD group, there was statistical difference between two groups (P < 0.05). Conclusions UBE and PELD are both effective surgical methods for DLSS. In UBE group, the operation time is shorter and the increase of postoperative DSCA is larger, which could provide guidance for surgical selection.

关 键 词：腰椎 椎管狭窄 内窥镜检查 单侧双通道 椎间盘切除术 经皮 

分 类 号：R681.533.2[医药卫生—骨科学] R443.7[医药卫生—外科学]