郭函 1刘家伦 1任龙喜 1唐新力 1梁得华 1刘正 1张彤童 1姜树东1
作者信息
- 1. 清华大学附属垂杨柳医院脊柱外科,北京 100022
- 折叠
摘要
Abstract
Objective To evaluate the clinical efficacy and technical advantages of unilateral biportal endoscopy(UBE)for treating lumbar spinal stenosis based on vertical projection positioning of the laminotomy window.Methods A retrospective analysis was conducted on 122 patients with lumbar spinal stenosis who underwent the UBE laminotomy window from May 2023 to August 2024.According to the UBE incision positioning method,patients were allocated to the laminotomy window positioning group(58 cases)and the intervertebral space positioning group(64 cases).Data on patients'age,gender,body mass index(BMI),surgical segment,time of operation,number of fluoroscopy exposures,postoperative wound drainage,and length of postoperative hospital stay were collected.Preoperative and postoperative imaging parameters—including spi-nal canal area and postoperative facet joint resection angle—were compared between the two groups.Additionally,the visual analog scale(VAS)for pain,Oswestry Disability Index(ODI),complication rate,and reoperation rate were compared be-fore and after surgery.At the final follow-up,overall clinical efficacy was evaluated using the modified Macnab criteria.Results All patients completed the surgery.No statistically significant differences were found between the two groups re-garding gender distribution,age,BMI,surgical segment distribution,postoperative wound drainage,length of postopera-tive hospital stay,follow-up duration,preoperative spinal canal area,or preoperative VAS and ODI scores(P>0.05).The laminotomy window positioning group had significantly shorter time of operation and fewer fluoroscopy exposures compared to the intervertebral space positioning group(P<0.05).In both groups,postoperative VAS scores were significantly lower than preoperative scores,and VAS scores at 3 months postoperatively were significantly lower than those at 1 month(P<0.05);however,there was no statistically significant difference between the 3-month scores and the final follow-up scores(P>0.05).At the final follow-up,ODI scores in both groups were lower than preoperative scores,and the ODI score in the laminotomy window positioning group was significantly lower than that in the intervertebral space positioning group(P<0.05).At the final follow-up,the excellent and good rate by the modified Macnab criteria was 93.10%in the laminot-omy window positioning group and 84.38%in the intervertebral space positioning group,with no statistically significant difference(P>0.05).The complication rates were 3.45%(2/58)in the laminotomy window positioning group and 12.50%(8/64)in the intervertebral space positioning group;the reoperation rates were 1.72%(1/58)and 4.69%(3/63),respectively,with no statistically significant differences(P>0.05).Imaging measurements showed that the spinal canal ar-ea significantly increased postoperatively compared to preoperative values in both groups(P<0.05),with no significant difference between the groups(P>0.05);however,the facet joint resection angle was significantly smaller in the laminoto-my window positioning group than in the intervertebral space positioning group(P<0.05).Conclusion The UBE tech-nique for treating lumbar spinal stenosis based on vertical projection positioning of the laminotomy window achieves satisfac-tory clinical efficacy and offers advantages such as simple operation,short time of operation,reduced fluoroscopy exposures,and fewer complications.关键词
腰椎管狭窄症/双通道/内镜手术/减压Key words
Lumbar spinal stenosis/Unilateral biportal endoscopy/Endoscopic surgery/Decompression分类
医药卫生
