单侧双通道内镜辅助下行极外侧入路经椎间孔腰椎融合技术在复发性腰椎间盘突出患者中的应用  

Application of extreme transforaminal lumbar interbody fusion technique assisted by unilateral biportal endoscopy to patients with recurrent lumbar disc herniation

作　　者：梁家铭 朱彪[2] 朱承跃 张伟[1] LIANG Jiaming;ZHU Biao;ZHU Chengyue;ZHANG Wei(Department of Orthopedics and Traumatology,Hangzhou Hospital of Traditional Chinese Medicine,Zhejiang Chinese Medical University,Hangzhou 310012,Zhejiang,China;Tengzhou Central People's Hospital,Tengzhou 277500,Shandong,China)

机构地区：[1]浙江中医药大学附属杭州市中医院骨伤科,浙江省杭州市310012 [2]山东省滕州市中心人民医院骨科,山东省滕州市277500

出　　处：《广西医学》2025年第2期207-211,共5页Guangxi Medical Journal

摘　　要：目的 探讨单侧双通道内镜(UBE)辅助下行极外侧入路经椎间孔腰椎融合技术(ExTLIF)治疗复发性腰椎间盘突出患者的安全性和有效性。方法 回顾性分析7例在UBE辅助下行ExTLIF治疗的复发性腰椎间盘突出患者的临床资料。记录患者的手术过程及术后随访情况。结果 7例患者均顺利完成手术,手术时间150~245(184.7±34.4)min,手术估计出血量105.0~210.5(157.8±36.5)mL,1例患者术后踇背伸肌力一过性下降。术后随访6~18(11.1±4.4)个月。术后1个月,7例患者的腰痛视觉模拟量表(VAS)评分从术前的(6.6±0.9)分降至(1.6±0.5)分,下肢疼痛VAS评分从术前的(7.0±0.8)分降至(1.1±1.0)分;3例患者下肢仍有麻木感。术后6个月,1例患者足部麻木感较术前明显减轻但仍稍有麻木,余2例患者麻木感缓解,出现踇背伸肌力下降的患者肌力恢复正常。随访期间无再次手术或术后感染等其他并发症发生。结论 UBE下行ExTLIF治疗复发性腰椎间盘突出患者手术创伤小,术后恢复快,并发症少,早期疗效满意。Objective To investigate the safeness and effectiveness of extreme transforaminal lumbar interbody fusion(ExTLIF)assisted by unilateral biportal endoscopy(UBE)for the treatment of patients with recurrent lumbar disc herniation.Methods The clinical data of 7 patients with recurrent lumbar disc herniation undergoing ExTLIF assisted by UBE were retrospectively analyzed.The states of surgical procedure and postoperative follow⁃up of patients were recorded.Results All 7 patients successfully completed surgery.The operation duration was 150-245(184.7±34.4)minutes,the operative bleeding volume estimated was 105.0~210.5(157.8±36.5)mL,and 1 patient had transient decrease in extensor hallucis dorsi muscle strength after operation.Patients were followed up for 6-18(11.1±4.4)months after operation.One month after surgery,the Visual Analogue Scale(VAS)score for low back pain decreased from 6.6±0.9 preoperatively to 1.6±0.5,and the VAS score for lower limb pain decreased from 7.0±0.8 preoperatively to 1.1±1.0 among 7 patients.Three patients still had feeling of numbness in lower limbs.Six months after operation,foot numbness of 1 patient was significantly relieved but still slightly numb as compared with before operation,and the numbness of the remaining 2 patients was relieved,and muscle strength of the patient with decreased extensor hallucis dorsi returned to normal.No reoperation or other complications such as postoperative infection occurred during follow⁃up.Conclusion UBE⁃assisted ExTLIF for the treatment of patients with recurrent lumbar disc herniation has less trauma in operation,faster recovery,fewer complications,and satisfactory early efficacy.

关 键 词：再次手术 复发性腰椎间盘突出 单侧双通道内镜 极外侧入路经椎间孔腰椎融合技术 临床疗效 

分 类 号：R681.57[医药卫生—骨科学]