中国骨伤2025，Vol.38Issue(11)：1093-1099,7.DOI:10.12200/j.issn.1003-0034.20240963
单边双通道内镜技术和经皮椎板间入路脊柱内镜技术治疗高度游离型腰椎间盘突出症的疗效比较
Comparison of efficacy between unilateral biportal endoscopic technique and percutaneous interlaminar approach spinal endoscopic technique in the treatment of highly migrated lumbar disc herniation
摘要
Abstract
Objective To compare the clinical efficacy of unilateral biportal endoscopic discectomy(UBE)and percuta-neous interlaminar endoscopic discectomy(PIED)in the treatment of highly migrated lumbar disc herniation(LDH).Methods A retrospective analysis was conducted on 43 patients with highly migrated LDH who underwent spinal endoscopic surgery be-tween January 2022 and December 2023.In the UBE group 22 patients included 8 males and 14 females,aged 49 to 59 years old with a mean of(54.13±2.07)years old.In the PIED group 21 patients included 11 males and 10 females,aged 49 to 59 years old with a mean of(55.04±2.80)years old.Perioperative parameters including intraoperative blood loss,operative time,and fluoroscopic exposures were compared between groups.Clinical outcomes were assessed using the visual analogue scale(VAS)for pain,Oswestry disability index(ODI),and modified MacNab criteria.Complications during the perioperative period and follow-up were recorded.Results In the PIED group,there were 3 cases of nerve injury,l case of residual nucleus pulpo-sus,and 1 case of dural injury.In the UBE group,there was 1 case of nerve injury and 1 case of cerebrospinal fluid leakage.No infections or major bleeding occurred in either group.All patients completed surgery and were followed up for at least 12 months.The UBE group had significantly more intraoperative blood loss(39.09±6.10)ml and more fluoroscopic exposures(6.45±0.26)than the PIED group(34.05±5.62)ml and(3.24±0.28)with significant difference(P＜0.05).Preoperative VAS and ODI showed no significant differences between two groups(P＞0.05).Both groups demonstrated significant improvements in VAS and ODI postoperatively(P＜0.00 1).At the 3rd days postoperatively,the UBE group had a significantly lower leg pain VAS(2.27±0.20)than the PIED gruop(2.95±0.24)with significant difference(P＜0.05),but no significant differences were observed at the first or 12th months(P＞0.05).No significant differences in ODI were found between two groups during fol-low-up(P＞0.05).At the 1st month postoperatively,according to modified MacNab criteria,15 patients got excellent results,4 good,and 2 fair in PIED group;and 18 patients got excellent results,2 good,and 2 fair in UBE group,with no significant difference between two groups(P＞0.05).Conclusion Both PIED and UBE are effective surgical methods for treating highly migrated LDH.Compared with PIED,UBE involves slightly longer operative time,more blood loss,and more fluoroscopic exposures,but carries a lower risk of nerve injury.关键词
高度游离型/椎间孔镜/单边双通道脊柱内镜/腰椎间盘突出症Key words
Highly migrated/Transforaminal endoscopic surgery/Unilateral biportal endoscopy discectomy/Lum-bar disc herniation分类
医药卫生引用本文复制引用
王龙,王二,李海东,闵继康..单边双通道内镜技术和经皮椎板间入路脊柱内镜技术治疗高度游离型腰椎间盘突出症的疗效比较[J].中国骨伤,2025,38(11):1093-1099,7.基金项目
浙江省基础公益研究项目(编号:LTGD23H090001)Zhejiang Provincial Basic Public Welfare Research Project(No.LTGD23H090001) （编号:LTGD23H090001）
