摘要
目的 比较经皮内镜下单侧椎板切开双侧减压(UE-ULBD)手术与后路腰椎椎体间融合术(PLIF)治疗腰椎管狭窄症(LSS)的临床疗效和安全性.方法 回顾性分析2021年3月至2023年3月在河南省洛阳正骨医院手术治疗的74例LSS患者的临床资料.依据手术方式的不同分为UE-ULBD组43例和PLIF组31例.比较两组患者的手术时间、术中出血量、术后24h引流量、住院周期和术前、术后第1天、术后3个月和术后1年的腰腿痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI);比较两组患者的术后并发症发生情况.结果 UE-ULBD组患者的手术时间、术中出血量、术后24h引流量、住院时间分别为(71.75±11.23)min、(47.35±3.31)mL、(58.31±6.31)mL及(5.57±1.25)d,明显短(少)于PLIF组的(119.45±18.760)min、(249.85±11.03)mL、(104.65±11.37)mL、(10.34±1.53)d,差异均有统计学意义(P<0.05);UE-ULBD组患者术后第1天、3个月、1年的腰腿疼VAS评分和ODI评分明显低于PILF组,差异均有统计学意义(P<0.05);UE-ULBD组患者的并发症总发生率为4.65%,明显低于PLIF组的19.35%,差异具有统计学意义(P<0.05).结论 UE-ULBD具有创伤少、手术时间短、恢复速度快等优点,且安全性较高,是治疗LSS的有效手术方法.
Abstract
Objective To compare the clinical efficacy and safety of percutaneous uniportal endoscopic unilat-eral laminotomy for bilateral decompression(UE-ULBD)with posterior lumbar interbody fusion(PLIF)for treating lum-bar spinal stenosis(LSS).Methods A retrospective analysis was conducted on the clinical data of 74 patients who re-ceived surgical treatment for LSS in Luoyang Orthopaedic-Traumatological Hospital of Henan Province from March 2021 to March 2023.According to the different surgical methods,the patients were divided into the UES-ULBD group:(43 cases)and the PLIF group(31 cases).Surgical time,intraoperative bleeding,24-hour postoperative drainage,hospi-tal stay,and Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)scores for lumbar pain before and after 1 day,3 months,and 1 year of operation were compared between the two groups.The overall incidence of postoperative complications was also compared between the two groups.Results In the UE-ULBD group,the operative time,intraop-erative blood loss,24-hour postoperative drainage volume,and hospital stay were(71.75±11.23)min,(47.35±3.31)mL,(58.31±6.31)mL,and(5.57±1.25)days,respectively,which were significantly shorter(less)than corresponding(119.45±18.760)min,(249.85±11.03)mL,(104.65±11.37)mL,(10.34±1.53)days in the PLIF group,and the differences were sta-tistically significant(P<0.05).The VAS and ODI scores for lumbar and leg pain in the UE-ULBD group were significant-ly lower than those in the PLIF group at 1 day,3 months,and 1 year postoperatively,with statistically significant differenc-es(P<0.05).The total incidence of postoperative complications in the UUE-ULBD group was 4.65%,significantly lower than 19.35%in the PLIF group(P<0.05).Conclusion UE-ULBD offers the advantages of minimal invasiveness,short-er operation time,faster recovery,and higher safety,making it an effective surgical method for treating LSS.
维普
万方数据