临床外科杂志 ›› 2024, Vol. 32 ›› Issue (3): 306-309.doi: 10.3969/j.issn.1005-6483.2024.03.023

• 论著 • 上一篇    下一篇

单侧双通道脊柱内镜辅助下单侧入路双侧减压技术治疗单节段腰椎管狭窄症的临床研究

王伟 李小川 黄春明 罗绍坚 卢明南 蓝根 姜成 陈炯灰 陈永龙 张镇武   

  1. 525232 广东医科大学附属高州市人民医院脊柱外科
  • 收稿日期:2023-04-13 出版日期:2024-03-20 发布日期:2024-03-20
  • 通讯作者: 李小川,Email:lixcgzph@163.com
  • 基金资助:
    广东省医学科学技术研究基金(B2023375);广东省中医药科研项目(20241380)

Clinical study of unilateral biportal endoscopy with unilateral laminotomy for bilateral decompression technique for the treatment of single-segment lumbar spinal stenosis

WANG Wei,LI Xiaochuan,HUANG Chunming,LUO Shaojian,LU Mingnan,LAN Gen,JIANG Cheng,CHEN Jionghui,CHEN Yonglong,ZHANG Zhenwu   

  1. Department of Spine Surgery,Gaozhou People’s Hospital affiliated to Guangdong Medical University,Guangdong,Gaozhou 525232,China
  • Received:2023-04-13 Online:2024-03-20 Published:2024-03-20

摘要: 目的 探讨单侧双通道脊柱内镜(unilateral biportal endoscopy,UBE)辅助下单侧入路双侧减压技术(unilateral laminotomy for bilateral decompression,ULBD)治疗单节段腰椎管狭窄症的安全性和有效性。方法 我院2020年7月~2021年5月采用UBE辅助下ULBD技术治疗单节段椎管狭窄病人35例,比较术前与术后1周、3个月、12个月、20个月术后随访时间的腰痛及腿痛的疼痛视觉模拟(visual analogue scale,VAS)评分和Oswestry功能障碍指数评分(Oswestry disability index,ODI)指数,观察术中、术后相关并发症发生情况。结果 获得完整术后随访35例,术后随访时间均超过20个月。1例病人在术后3天出现少许脑脊液漏,予以卧床休息及加强营养等处理后伤口痊愈。术后20个月,VAS评分由术前的(4.51±1.09)分降低至(1.91±0.47)分,腿痛的VAS评分由术前的(5.71±1.15)分降低至(2.54±0.56)分,ODI由0.50±0.09降为0.22±0.04,差异有统计学意义(P<0.05)。结论 采用UBE辅助下ULBD技术治疗单节段腰椎管狭窄手术损伤较小,手术视野开阔,能较好地保护脊柱周围软组织。

关键词: 单侧入路双侧减压技术;单节段椎管狭窄;临床研究

Abstract: Objective To investigate the safety and effectiveness of the unilateral biportal endoscopy with unilateral laminotomy for bilateral decompression (ULBD) technique to treat patients with single-segment lumbar spinal stenosis.Methods 35 Patients with single-segment spinal stenosis treated by the ULBD method in the Department of Spine Surgery,Gaozhou People’s Hospital from July 2020 to May 2021 were selected in this study.The visual analogue scale (VAS) score and Oswestry disability index (ODI) score of low back pain and leg pain were compared between pre-operation and postoperative follow-up at 1 week,3,12 and 20 months.Besides,intraoperative and postoperative complications were statistically analyzed.Results A complete follow-up of 35 cases was obtained with over 20 months.A mild cerebrospinal fluid leak occurred 3 days after surgery in one case whose wound healed after taking enough rest and receiving nutrition.The VAS score for low back pain decreased from 4.51±1.09 before surgery to 1.91±0.47 after the surgery,the VAS score for leg pain reduced from 5.71±1.15 before the surgery to 2.54±0.56 after the surgery,and the ODI index dropped from 0.50±0.09 to 0.22±0.04,with a statistically significant difference (P<0.05).Conclusion Patients with single-segment lumbar spinal stenosis can be treated with the unilateral biportal endoscopy-guided ULBD technique which is characterized by less invasiveness,clear visual fields,and the protection of the soft tissues around the spine.

Key words: unilateral laminotomy for bilateral decompression; single-segment lumbar spinal stenosis; clinical study

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