中国骨伤2025，Vol.38Issue(9)：924-929,6.DOI:10.12200/j.issn.1003-0034.20250430
侧入路双通道法经皮内镜下髓核摘除术治疗高度游离型腰椎间盘突出症
Percutaneous endoscopic discectomy with lateral approach and dual-channel method for the treatment of highly free lumbar disc herniation
摘要
Abstract
Objective To explore clinical efficacy of percutaneous endoscopic discectomy with a lateral approach and dual-channel method in treating highly free lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 54 patients with highly free LDH who were treated with spinal endoscopic techniques from January 2021 to December 2022.Twenty-seven patients were treated with lateral approach dual-channel(lateral approach dual-channel group),including 16 males and 11 females,with an average age of(54.6±10.5)years old.Twenty-seven patients were treated with unilateral biportal endoscopic(UBE group),including 17 males and 10 females,with an average age of(52.9±12.3)years old.The number of in-traoperative fluoroscopy,operation time and hospital stay,as well as visual analogue scale(VAS)and Oswestry diability index(ODI)of low back and leg pain between two patients before operation,1 day,1,3,and 12 months after operation,and the effi-cacy was evaluated by the modified MacNab criteria at 12 mohths after operation.Results All patients were successfully com-pleted surgical and were followed up,the time raged from 12 to 22 months with an average of(13.57±4.12)months.There was no statistically significant difference in operation time between two groups(P＞0.05).The hospital stay of lateral approach dual-channel group was(3.9±1.1)days,which was shorter than that of UBE group(6.5±1.4)days,the number of intraoperative flu-oroscopy in lateral approach dual-channel group was(12.7±2.1)times,which was more than that in UBE group(6.6±1.3)times,the differences were statistically significant(t=5.197,-7.532;P＜0.05).VAS and ODI for low back pain at 1 day and 1 month after operation,and VAS for leg pain at 1 day after operation of lateral approach dual-channel group were superior to those of UBE group,and the differences were statistically significant(P＜0.05).However,there were no statistically significant differences in VAS and ODI for low back and leg pain between two groups before operation and 3 and 12 months after operation(P＞0.05).VAS and ODI of low back and leg pain were significantly improved at each time point before and after operation in both groups,and the difference were statistically significant(P＜0.05).At 12 months after operation,according to the modified MacNab criteria,the excellent and good rates of therapeutic effects between lateral approach dual-channel group and UBE group were 92.6％(25/27)and 88.9％(24/27),respectively,and the difference was not statistically significant(x2=0.22,P＞0.05).Conclusion For patients with highly free lumbar intervertebral disc protrusion,both of lateral approach dual-channel method and UBE endoscopic surgery are safe and effective.Endoscopic surgery with lateral approach and dual-channel method could be performed under local anesthesia,allowing for the removal of the nucleus pulposus under direct vision.It is simpler,more efficient.关键词
腰椎/椎间盘移位/椎间盘摘除术/外科手术,内窥镜Key words
Lumbar vertebrace/Intervertebral disc displacement/Discectomy/Surgical procedures,endoscopic分类
医药卫生引用本文复制引用
陈启明,余春华,陈刚,许汉荣,景易彪,芦银江,陶善春,吴剑波..侧入路双通道法经皮内镜下髓核摘除术治疗高度游离型腰椎间盘突出症[J].中国骨伤,2025,38(9):924-929,6.基金项目
浙江省医药卫生科技计划项目(编号:2025KY1709)Zhejiang Medical Science and Technology Plan Project(No.2025KY1709) （编号:2025KY1709）
