摘要
目的:探讨单边双通道内镜术(Unilateral Biportal Endoscopy,UBE)与开放腰椎间盘切除术(Open Lumbar Discectomy,OLD)在治疗腰椎间盘突出症中的疗效对比,以及2种术式对患者腰椎椎旁肌的短期影响。方法:回顾性分析2020年1月至2022年12月,于本院住院的86例腰椎间盘突出症患者资料,其中45例接受UBE治疗,41例接受OLD治疗。比较2组患者的一般资料、围手术期手术时间、术中出血量、住院时长及并发症情况。分别于术前、术后3个月和术后1年,采用视觉模拟量表(Visual Analogue Scale,VAS)和Oswestry残疾指数(Oswestry Disability Index,ODI)对患者症状改善情况进行评价。通过术前及术后1年MRI,比较腰椎椎旁肌的改变情况。结果:UBE组患者的手术时间长于OLD组,但在切口长度、术中出血量、住院时间显著低于OLD组(P<0.05),2组的并发症发生率差异无统计学意义(P>0.05)。2组患者术后3个月及1年VAS评分和ODI评分均较术前减低,且UBE组术后1年VAS评分低于OLD组(P>0.05)。术后1年,2组患者的多裂肌横断面积均明显小于术前;UBE组术后1年多裂肌横断面积大于OLD组,但多裂肌横断面积变化率小于OLD组(P<0.05)。结论:UBE与OLD治疗腰椎间盘突出症的近期临床疗效良好且相似,但UBE对术区多裂肌的近期损伤程度小于OLD。
Objective:To investigate the efficacy of Unilateral biportal endoscopy(UBE)and open lumbar discectomy(OLD)in lumbar disc herniation and the short-term effects of the two procedures on the lumbar paravertebral muscles.Methods:Data of 86 patients with lumbar disc herniation admitted in our hospital from January 2020 to December 2022,45 underwent UBE,41 underwent OLD.General data between the two groups,perioperative operation time,intraoperative blood loss,hospitalization length and complications.Patients were evaluated by Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)before,3 months and 1 year after surgery.Perivertebral muscle changes in the lumbar spine were compared by preoperative and 1 year postoperative MRI.Results:The surgery time in the UBE group was longer than the OLD group,and the incision length,intraoperative bleeding,and hospital stay were significantly lower than the OLD group(<0.05).There was no significant difference in complication rate between the patients in the two groups(>0.05).The VAS and ODI scores decreased at 3 months and 1 year after surgery,and the VAS score was lower in the UBE group than in the OLD group(<0.05).The area in both groups was significantly smaller than the preoperative area:that in the UBE group was greater than that in the OLD group;The change rate in the UBE group was less than that in the OLD group(<0.05).Conclusion:The recent clinical efficacy of UBE and OLD for lumbar disc herniation is good and similar,and the recent effect of UBE on multifidus injury in the surgical area is significantly less than that of OLD.
作者
徐瑞辰
王兴
程文丽
庞华军
张伟亚
XYU Ruichen;WANG Xing;CHENG Wenli;PANG Huajun;ZHANG Weiya(Medical Imaging Department of Shihezi People's Hospital,Shihezi,Xinjiang 832099,China;Spinal Surgery Department,Shihezi People's Hospital,Shihezi,Xinjiang 832099,China;Department of Anesthesiology,Shihezi People's Hospital,Shihezi,Xinjiang 832099,China)
出处
《农垦医学》
2025年第1期48-51,78,共5页
Journal of Nongken Medicine
基金
新疆生产建设兵团第八师石河子市科技计划项目(2023SF04)。
关键词
腰椎
单边双通道内镜术
MRI
椎旁肌
Lumbar vertebrae
Unilateral biportal endoscopy
MRI
Paravertebral muscle
作者简介
通信作者:王兴,男,主治医师,从事骨外科学临床及基础研究工作。
