摘要
目的比较单侧双通道内镜技术(unilateral biportal endoscopy,UBE)和开放式椎板切除术(open laminectomy,OL)治疗腰椎管狭窄症(lumbar spinal stenosis,LSS)的安全性和有效性。方法收集2020年7月—2022年7月在我院治疗的69例诊断为LSS的患者,其中32例接受UBE手术治疗,37例接受OL手术治疗。比较UBE组和OL组患者的术前基线资料、术前和术后的临床和实验室指标、随访期间的临床疗效指标,以及并发症的发生率等。结果两组手术方式的术前基线、平均手术时间、平均随访时间,差异无统计学意义(P>0.05)。但是,UBE组患者的血红蛋白下降量、术后引流量、平均住院时间、术后实验室指标均显著低于OL组,两组差异有统计学意义(P<0.05)。此外,UBE组术后第3天腰痛和腿痛的视觉模拟评分(visual analogue score,VAS)显著降低(P<0.05),术后3 d和1个月日本骨科协会(Japanese Orthopedics Association,JOA)评分显著降低,以及术后1个月功能障碍指数(oswestry disability index,ODI)显著降低(P<0.05)。术后3个月和6个月的VAS、JOA评分、ODI指数均无显著性差异(P>0.05)。结论这项研究表明两组手术方式都能获得满意的治疗效果;但是,UBE组具有诸多优势,包括减少组织损伤、术后炎症反应较轻、术后早期疼痛较轻、功能恢复较快,但两者远期临床疗效相近。
Objective The aim of this study was to compare the safety and efficacy of unilateral biportal endoscopy(UBE)with open laminectomy(OL)for lumbar spinal stenosis(LSS)treatment.Methods This study included 69 patients diagnosed as LSS who were treated in a single medical center from July 2020 to July 2022.Among them,32 patients were treated with UBE surgical treatment and 37 patients were treated with OL surgical treatment.This study compared preoperative baseline data,clinical and laboratory indicators before and after surgery,clinical efficacy indicators during follow-up,and incidence of complications between the UBE and OL groups.Results There were no statistically significant differences in preoperative baseline,average surgical time,and average follow-up time between the two groups of surgical methods(P>0.05).But the intraoperative hemoglobin decrease,postoperative drainage volume,average hospital stay,postoperative laboratory indicators of patients in the UBE group were significantly lower than those in the OL group,and the differences between the two groups were statistically significant(P<0.05).In addition,the visual analog score(VAS)of low back pain and leg pain in UBE group was significantly lower on the 3 rd day after operation(P<0.05),the Japanese Orthopedics Association(JOA)score was significantly lower on the 3 rd day and in the 1 st month after operation,and the Oswestry Disability Index(ODI)score was significantly lower in the 1 st month after operation(P<0.05).The VAS,JOA score and ODI were not significantly different in the 3 rd and 6 th month after operation(P>0.05).Conclusion This study shows that the two surgical methods can obtain satisfactory treatment results.But the UBE group has many advantages,including less tissue damage,less postoperative inflammation,less postoperative early pain,and faster functional recovery.However,the long-term clinical efficacy of both groups is similar.
作者
闫朋磊
刘维曦
金丹杰
刘刚
杨志成
刘瑞平
YAN Penglei;LIU Weixi;JIN Danjie;LIU Gang;YANG Zhicheng;LIU Ruiping(Graduate School of Bengbu Medical College,Bengbu,Anhui 233030,China;Department of Orthopaedics,The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China)
出处
《手术电子杂志》
2023年第3期17-23,共7页
Electronic Journal of Medical Operations
基金
常州市医学领军人才培养项目(2016CZLJ011)
关键词
腰椎退行性疾病
腰椎管狭窄症
脊柱内窥镜
并发症
lumbar degenerative disease
lumbar spinal stenosis
spinal endoscopy
complications
作者简介
通讯作者:刘瑞平,Email:liuruiping216@yahoo.com
