摘要
Abstract
Objective To investigate the early clinical efficacy,safety,and application value of one-hole split endoscopy(OSE)-assisted transforaminal lumbar interbody fusion(TLIF)in the treatment of lumbar degenerative diseases.Methods A retrospective analysis was conducted on 17 patients with lumbar degenerative diseases who underwent OSE-assisted TLIF be-tween June 2023 and June 2024.There were 10 males and 7 females,with a mean of(55.30±6.52)years old ranging 43 to 65 years.The disease duration ranged from 3 to 36 months with a mean of(12.4±13.3)months.The disease distribution was as fol-lows:lumbar disc herniation(7 cases),lumbar spinal stenosis(5 cases),and lumbar spondylolisthesis(2 cases).Operative time,incision length,intraoperative blood loss,number of intraoperative fluoroscopic exposures,time to ambulation,postopera-tive hospital stay,and complications were recorded.The dural sac area at the affected segment,visual analogue scale(VAS)for low back pain and leg pain,and Oswestry disability index(ODI)were recorded preoperatively and postoperatively.The modified MacNab criteria were used to evaluate the surgical outcome at the final follow-up.Results All 17 patients successfully underwent surgery and were followed up for 3 to 15 months with a mean of(8.4±3.3)months.The operative time was 120 to 200 minutes with a mean of(143.2±22.0)minutes,the incision length on the decompression side was 1.80 to 4.00 cm with a mean of(2.56±0.65)cm,intraoperative blood loss was 50 to 300 ml with a mean of(161.2±72.5)ml,the number of fluoro-scopic exposures was 15 to 38 with a mean of(23.4±6.5),time to ambulation was 24 to 72 hours with a mean of(49.2±11.9)hours,and postoperative hospital stay was 3 to 9 days with a mean of(4.9±1.5)days.Two patients developed transient lower limb pain and numbness,which completely resolved with conservative treatment.The postoperative dural sac area was(121.47±14.90)mm2,which was significantly larger than the preoperative area(51.47±7.69)mm2(P＜0.001).The VAS for low back pain were(6.23±1.64),(2.94±1.43),and(1.94±0.75)at preoperation,3 days postoperation,and final follow-up,respec-tively;the VAS for leg pain were(7.06±1.43),(2.35±1.17),and(2.06±0.90)at the same time points.The VAS at all postop-erative time points were significantly lower than preoperative scores(P＜0.001).The ODI at final follow-up was(25.29±8.15)％,which was significantly better than the preoperative ODI of(82.35±5.16)％(P＜0.001).At the final follow-up,the MacNab surgical outcome was excellent in 11 cases,good in 4 cases,and fair in 2 cases.Conclusion OSE-assisted TLIF is an effective,safe,and minimally invasive technique with a gentle learning curve for the treatment of lumbar degenerative dis-eases,capable of effectively relieving symptoms and improving function.关键词
经椎间孔腰椎椎间融合术/单孔分体内镜/脊柱内镜/腰椎退行性疾病Key words
Transforaminal lumbar interbody fusion/One-hole split endoscopy/Spinal endoscopy/Lumbar degen-erative diseases分类
医药卫生
