单侧双通道内镜腰椎融合治疗腰椎退行性疾病  

Unilateral biportal endoscopic lumbar interbody fusion for lumbar degenerative diseases

作　　者：邹亚琪 李大鹏[1] 曹文炳 朱志诚 ZOU Ya-qi;LI Da-peng;CAOWen-bing;ZHU Zhi-cheng(Department of Spine Surgery,The Affiliated Hospital,Jiangsu University,Zhenjiang,Jiangsu 212000,China)

机构地区：[1]江苏大学附属医院脊柱外科,江苏镇江212000

出　　处：《中国矫形外科杂志》2025年第2期176-179,共4页Orthopedic Journal of China

摘　　要：[目的]评估单侧双通道内镜腰椎融合(unilateral biportal endoscopiy lumbar interbody fusion,UBE-LIF)治疗腰椎退行性疾病的疗效。[方法]回顾性分析2019年—2022年在本院接受UBE-LIF治疗的单节段腰椎退行性疾病患者的临床资料。评价临床及影像结果。[结果]413例患者均顺利手术,手术时间平均(158.3±17.2) min,术中出血量平均(217.5±22.1) ml,随访时间平均(17.3±3.1)个月。与术前相比,术后6个月及末次随访时,腰痛VAS[(6.9±0.6),(1.6±0.3),(1.4±0.2),P<0.001]、腿痛VAS[(8.0±0.7),(1.5±0.5),(1.3±0.4),P<0.001]及ODI评分[(78.5±6.1),(17.5±3.7),(17.5±3.7),P<0.001]均显著减少。影像方面,与术前相比,术后6个月及末次随访时,椎管面积[(128.6±19.8) mm2,(238.2±12.5) mm2,(223.4±12.7) mm2,P<0.001]、侧隐窝矢状径[(1.5±0.5) mm,(6.3±0.5) mm,(6.0±0.5) mm,P<0.001]及椎间隙高度[(7.5±0.7) mm,(12.3±0.5) mm,(11.8±0.5) mm,P<0.001]均显著改善。术后第6个月CT示融合率达92.5%,末次随访时Mac Nab优良率达94.4%。术后并发症发生率为4.6%。[结论]UBE-LIF技术手术时间较长,但总体上临床效果较好,术后并发症率较低。[Objective]To evaluate the efficacy of unilateral biportal endoscopic lumbar interbody fusion(UBE-LIF)in the treatmentof degenerative lumbar diseases.[Methods]A retrospective analysis was conducted on 413 patients who had single-segment degenerativelumbar diseases treated by UBE-LIF treatment at our hospital from 2019 to 2022.The clinical and imaging documents were evaluated.[Re-sults]All the patients had UBE-LIF performed successfully with the average operative time of(158.3±17.2)min,the average intraopera-tive blood loss of(217.5±22.1)ml,and were followed up for a mean of(17.3±3.1)months.With time preoperatively,6 months after surgeryand at the last follow-up,the low back pain VAS[(6.9±0.6),(1.6±0.3),(1.4±0.2),P<0.001],leg pain VAS[(8.0±0.7),(1.5±0.5),(1.3±0.4),P<0.001]and ODI scores[(78.5±6.1),(17.5±3.7),(17.5±3.7),P<0.001]were significantly declined.In term of imaging,the spinal canal ar-ea[(128.6±19.8)mm2,(238.2±12.5)mm2,(223.4±12.7)mm2,P<0.001],lateral recess sagittal diameter[(1.5±0.5)mm,(6.3±0.5)mm,(6.0±0.5)mm,P<0.001]and intervertebral height[(7.5±0.7)mm,(12.3±0.5)mm,(11.8±0.5)mm,P<0.001]were significantly improved over thetime period abovementioned.The CT showed that the fusion rate was 92.5%6 months after operation,while the MacNab excellent and goodrate of the clinical consequence was of 94.4%at the last follow-up and the postoperative complication rate was of 4.6%.[Conclusion]Al-though the UBE-LIF consumed longer operation time,it achieves good overall clinical outcome,with low postoperative complication.

关 键 词：腰椎退行性疾病 单侧双通道内镜腰椎融合 临床疗效 并发症 

分 类 号：R681.5[医药卫生—骨科学]