UBE与BEIS治疗L_(5)S_(1)腰椎间盘突出症的疗效和术后腰椎稳定性研究  

Clinical Study on the Effect of UBE and BEIS Techniques in Treating L_(5)S_(1) Lumbar Disc Herniation and Their Impact on Postoperative Lumbar Stability

作　　者：刘幸明 陈欢[1,2] 尤冬春 郭伟锋 吴荣海[1,2] 郑周杭 张宇 Liu Xingming;Chen Huan;You Dongchun;Guo Weifeng;Wu Ronghai;Zheng Zhouhang;Zhang Yu(Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,China;Department of Orthopaedics,The Second Hospital of Traditional Chinese Medicine of Guangdong Province,Guangzhou 510095,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省第二中医院骨科,广东广州510095

出　　处：《实用骨科杂志》2025年第1期25-30,36,共7页Journal of Practical Orthopaedics

基　　金：广东省基础与应用基础研究基金省企联合基金(2022A1515220093)。

摘　　要：目的比较单侧双通道内镜(unilateral biportal endoscopy,UBE)技术和BEIS(broad,easy,immediate,surgery)技术治疗L_(5)S_(1)腰椎间盘突出症的临床疗效及对术后腰椎稳定性的影响。方法回顾性分析2021年10月至2023年3月广东省第二中医院骨科收治的共120例L_(5)S_(1)腰椎间盘突出症患者资料,其中UBE组男29例,女29例;年龄26~66岁,平均(42.54±7.50)岁。BEIS组男30例,女32例;年龄28~68岁,平均(43.15±7.14)岁。比较两组手术时间、透视次数、术中出血量、住院时间、视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI),椎旁肌肉脂肪浸润率、腰椎前凸角(lumbar lordosis,LL)、骶骨倾斜角(sacral slope,SS)、骨盆倾斜角(pelvic tilt,PT)的差异。结果BEIS组平均手术时间(70.08±13.41)min,透视次数(11.47±1.40)次,术中出血量(12.74±7.89)mL;UBE组平均手术时间(60.45±16.82)min,透视次数(4.58±1.23)次,术中出血量(28.45±8.47)mL。UBE组在手术时间、透视次数方面均优于BEIS组,术中出血量多于BEIS组(P<0.05)。UBE组随访12~14个月,平均随访时间(12.10±0.10)个月,BEIS组随访12~15个月,平均随访时间(13.20±0.10)个月,BEIS组术后12个月VAS平均(2.23±1.32)分,ODI平均(8.98±3.47)%;UBE组术后12个月VAS平均(2.91±0.98)分,ODI平均(11.62±3.51)%,BEIS组术后12个月临床症状均优于UBE组(P<0.05)。脂肪浸润率方面:BEIS组术后12个月(36.05±3.95)%,UBE组术后12个月(38.12±2.98)%,BEIS组较UBE组改善明显(P<0.05)。BEIS组术后12个月LL、PT、SS分别为(41.05±3.95)°、(15.05±4.05)°、(38.05±4.09)°,UBE组术后12个月LL、PT、SS分别为(37.17±2.15)°、(18.87±2.77)°、(35.87±3.51)°,BEIS组较UBE组LL、SS角度变大,PT角度变小(P<0.05)。UBE组2例患者术后有下肢疼痛情况,BEIS组1例患者术后下肢疼痛,予对症处理后均缓解。结论UBE技术和BEIS技术治疗L_(5)S_(1)腰椎间盘突出症均安全有效,但是对于患者术后早期脊柱Objective To compare the clinical efficacy and postoperative lumbar stability of unilateral biportal endoscopy(UBE)and BEIS(broad,easy,immediate,surgery)techniques in the treatment of L_(5)S_(1) lumbar disc herniation.Methods Retrospective analysis was conducted on the data of 120 patients with L_(5)S_(1) lumbar disc herniation admitted to the Orthopaedics Department of Guangdong Second Traditional Chinese Medicine Hospital from October 2021 to March 2023.In the UBE group,there were 29 males and 29 females;the age ranged from 26 to 66 years old,with an average of(42.54±7.50)years.In the BEIS group,there were 30 males and 32 females;the age range was 28 to 68 years old,with an average of(43.15±7.14)years.The differences in surgical time,fluoroscopy frequency,intraoperative blood loss,hospital stay,visual analogue scale(VAS),Oswestry disability index(ODI),paraspinal muscle fat infiltration rate,lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT)were compared between the two groups.Results The BEIS group had an average surgical time of(70.08±13.41)min,an average fluoroscopy frequency of(11.47±1.40)times,and an average intraoperative blood loss of(12.74±7.89)mL.The UBE group had an average surgical time of(60.45±16.82)min,an average fluoroscopy frequency of(4.58±1.23)times,and an average intraoperative blood loss of(28.45±8.47)mL.The UBE group was superior to the BEIS group in terms of surgical time and fluoroscopy frequency,but had more intraoperative blood loss than the BEIS group(P<0.05).The UBE group was followed up for 12~14 months,with an average follow-up time of(12.10±0.10)months.The BEIS group was followed up for 12~15 months,with an average follow-up time of(13.20±0.10)months.At 12 months after surgery,the BEIS group had an average VAS score of(2.23±1.32)and an average ODI score of(8.98±3.47)%.The UBE group had an average VAS score of(2.91±0.98)and an average ODI score of(11.62±3.51)%.The clinical symptoms of the BEIS group were better than those of the UBE group at 12 months after surgery(P<

关 键 词：单侧双通道内镜 BEIS技术 腰椎间盘突出症 腰椎稳定性 

分 类 号：R681.53[医药卫生—骨科学]