|本期目录/Table of Contents|

[1]谷艳超,李莹,谢维,等.单边双通道脊柱内镜技术治疗腰椎椎管狭窄症临床分析[J].国际骨科学杂志,2021,05:323.
　GU Yanchao,LI Ying,XIE Wei,et al.Clinical analysis of unilateral biportal endoscopy for treatment of lumbar spinal stenosis[J].International Journal of Orthopaedics,2021,05:323.
点击复制

单边双通道脊柱内镜技术治疗腰椎椎管狭窄症临床分析(PDF)

《国际骨科学杂志》[ISSN:1673-7083/CN:31-1952/R]

期数:
2021年05期
页码:
323
栏目:
临床研究
出版日期:
2021-10-01

文章信息/Info

Title:
Clinical analysis of unilateral biportal endoscopy for treatment of lumbar spinal stenosis
作者:
谷艳超; 李莹; 谢维; 刘鏐; 唐谨
430000 武汉, 湖北六七二中西医结合骨科医院 湖北中医药大学附属骨伤医院脊柱外科
Author(s):
GU Yanchao;  LI Ying;  XIE Wei;  LIU Liu;  TANG Jin.
Department of Spine Surgery, Hubei 672 Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine, Orthopedics Hospital Affiliated to Hubei University of Traditional Chinese Medicine, Wuhan 430000, China
关键词:
单边双通道脊柱内镜技术;  腰椎椎管狭窄;  微创手术
Keywords:
Unilateral biportal endoscopy;  Lumbar spinal stenosis;  Minimally invasive operation.
分类号:
-
DOI:
10.3969/j.issn.1673-7083.2021.05.014
文献标识码:
-
摘要:
目的 探讨单边双通道脊柱内镜技术(UBE)治疗腰椎椎管狭窄症患者的临床效果。方法 选取2020年6月1日至2020年9月30日于湖北六七二中西医结合骨科医院计划行手术治疗的腰椎椎管狭窄症患者31例,行UBE手术。其中男11例,女20例,年龄为(62.8±8.1)岁(38～75岁)。手术节段为L3/L4 3例、L4/L5 16例、L5/S1 12例。记录31名患者术前、术后2 d、术后1个月、术后3个月的疼痛视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评分,末次随访改良MacNab标准评价,以及手术时间、术中硬膜破裂例数、平均住院日。结果 31例患者均顺利完成手术,无术中改变手术方式病例。手术时间为(55.1±11.7)min(43～87 min)。术中硬膜破裂1例(3.2%)。31例患者均顺利出院,住院时间(5.2±3.1)d(3～10 d)。患者术后均获得随访,随访时间(5.4±2.9)个月(3～9个月)。患者VAS评分术前为(8.1±1.1)分,术后2 d为(3.5±1.3)分,术后1个月为(2.3±1.1)分,术后3个月为(0.5±0.4)分,术后各时间节点与术前相比均有差异(P<0.05)。ODI评分术前为(66.2±12.8)%,术后2 d为(37.4±9.9)%,术后1个月为(24.2±8.3)%,术后3个月为(11.1±2.5)%,术后各时间节点与术前相比均有差异(P<0.05)。末次随访改良MacNab标准评价患者优良率为90%,其中优64%(20例),良26%(8例),可6%(2例),差3%(1例)。结论 UBE技术具有微创、视野清晰、操作灵活、减压彻底、学习曲线平缓的特点,为腰椎椎管狭窄症的治疗提供了一种微创方法,值得临床医生借鉴与尝试。
Abstract:
Objective This study aimed to explore the clinical effects of unilateral biportal endoscopy(UBE)in treating lumbar spinal stenosis.Methods From June 1, 2020 to September 30, 2020, according to the inclusion and exclusion criteria, 31 patients were selecte

参考文献/References

[1] Costa F, Sassi M, Cardia A, et al. Degenerative lumbar spinal stenosis: analysis of results in a series of 374 patients treated with unilateral laminotomy for bilateral micro-decompression[J]. Neurosurg Spine, 2007, 7(6): 579-586.
[2] Hu ZJ, Fang XQ, Zhou ZJ, et al. Effect and possible mechanism of muscle-splitting approach on multifidusmuscle injury and atrophy after posterior lumbar spine surgery[J]. Bone Joint Surg Am, 2013, 95(24): e1921-e1929.
[3] Sairyo K, Sakai T, Higashino K, et al. Complications of endoscopic lumbar decompression surgery[J]. Minim Invasive Neurosurg, 2010, 53(4): 175-178.
[4] de Antoni DJ, Claro ML, Poehling GG, et al. Translaminar lumbar epidural endoscopy: anatomy, technique, and indications[J]. Arthroscopy, 1996, 12(3): 330-334.
[5] Soliman HM. Irrigation endoscopic discectomy: a novel percutaneous approach for lumbar disc prolapse[J]. Eur Spine J, 2013, 22(5): 1037-1044.
[6] Soliman HM. Irrigation endoscopic decompressive laminotomy. A new endoscopic approach for spinal stenosis decompression[J]. Spine J, 2015, 15(10): 2282-2289.
[7] Hwa Eum J, Hwa Heo D, Son SK, et al. Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results[J]. J Neurosurg Spine, 2016, 24(4): 602-607.
[8] Heo DH, Son SK, Eum JH, et al. Fully endoscopic lumbar inter-body fusion using a percutaneous unilateral biportal endoscopic technique:technical note and preliminary clinical results[J]. Neurosurg Focus, 2017, 43(2): E8.
[9] Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery[J]. Neurosurg Focus, 2019, 46(5): E9.
[10] Kim JE, Choi DJ. Unilateral biportal endoscopic decompression by 30 degrees endoscopy in lumbar spinal stenosis: technical note and preliminary report[J]. J Orthop, 2018, 2: 366-371.
[11] Eun SS, Eum JH, Lee SH, et al. Biportal endoscopic lumbar decompression for lumbar disk herniation and spinal canal stenosis: a technical Note[J]. J Neurol Surg A Cent Eur Neurosurg, 2017, 78(4): 390-396.
[12] Ahn JS, Lee HJ, Park EJ, et al. Multifidus muscle changes after biportal endoscopic spinal surgery(bess): magnetic resonance imaging evaluation[J]. World Neurosurgery, 2019, 130: e525-e534.
[13] Park SM, Kim HJ, Kim GU, et al. Learning curve for lumbar decompressive laminectomy in biportal endoscopic spinal surgery using the cumula-tive summation test for learning curve[J]. World Neurosurg, 2019, 122: e1007-e1013.
[14] Albany NY. Prospective randomized controlled trial of tranexamic acid use during elective lumbar spine surgery,preliminary results[J]. Spine J, 2021, 21(Suppl 9): S102-S103.
[15] 康友伟, 杨雪飞, 于滨生. 腰椎术后脑脊液漏治疗的研究进展[J]. 脊柱外科杂志, 2020, 18(4): 278-281.
[16] Kim N, Jung SB. Percutaneous unilateral biportal endoscopic spine surgery using a 30-degree arthroscope in patients with severe lumbar spinal stenosis: a technical note[J]. Clin Spine Surg, 2019, 32(8): 324-329.
[17] Song KS, Lee CW, Moon JG. Biportal endoscopic spinal surgery for bilateral lumbar foraminal decompression by switching surgeon's position and primary 2 portals: a report of 2 cases with technical Note[J]. Neurospine, 2019, 16(1): 138-147.

备注/Memo

备注/Memo:
通信作者: 李莹 E-mail: 50957261@qq.com
更新日期/Last Update: 2021-10-01