Objective To explore the clinical efficacy of V-shape bichannel spinal endoscopy(VBE)in the treatment of degenerative lumbar spondylolisthesis(DLS)in elderly patients.Methods A total of 110 patients with DLS admitted to Wu'an First People's Hospital from June 2017 to April 2023 were selected as the research subjects.According to the surgical plan,these patients were divided into the minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)group and the VBE group,with 55 patients in each group.The general indicators of patients in the two groups during and after surgery,inclu-ding the length of the surgical incision,operation time,number of X-ray fluoroscopy,intraoperative blood loss,hospitalization time,and bed rest time were recorded.Before surgery and three,six months after surgery,the visual analogue scale(VAS)was used to assess the degree of pain in the back and legs,and the Oswestry disability index(ODI)was used to assess the lumbar function of the patients.The Brantigan score was used to assess bone fusion in patients at three months after surgery.X-ray films were taken before surgery and three,six months after surgery to measure the spondylolisthesis degree,intervertebral height,spondylolisthesis angle,and sagittal Cobb angle at the surgical segment.The Japanese Orthopaedic Association(JOA)score was used to assess the excellent and good rate of lumbar function in patients at six months after surgery.The incidence of postoperative complications of patients in both groups was recorded.Results The length of surgical incision,operation time,bed rest time,and hospitalization time of patients in the VBE group were significantly shorter than those in the MIS-TLIF group,and the intraoperative blood loss and X-ray fluoroscopy times were significantly less than those in the MIS-TLIF group(P＜0.05).There was no significant difference in VAS scores for low back pain and leg pain and ODI index between the two groups before surgery(P＞0.05).The VAS scores for low back pain and leg pain and the ODI index of patients in both groups at three and six months after surgery were significantly lower than those before surgery(P＜0.05).There was no significant difference in the VAS scores for low back pain and leg pain and ODI index between the VBE group and the MIS-TLIF group at three and six months after surgery(P＞0.05).There was no significant difference in the distribution of Brantigan scores of patients between the VBE group and the MIS-TLIF group(P＞0.05).There was no significant difference in the sagittal Cobb angle,intervertebral height,spondylolisthesis angle,and spondylolisthesis degree at the surgical segment of patients between the two groups before surgery(P＞0.05).The sagittal Cobb angle and intervertebral height at the surgical segment of patients in both groups at three and six months after surgery were significantly higher than those before surgery(P＜0.05),while the spondylolisthesis angle and spondylolisthesis degree were significantly lower than those before surgery(P＜0.05).There was no significant difference in the sagittal Cobb angle,intervertebral height,spondylolisthesis angle and spondylolisthesis degree at the surgical segment of patients between the two groups at three and six months after surgery(P＞0.05).At six months after surgery,the excellent and good rate of lumbar function in the VBE group and the MIS-TLIF group was 100.00％(55/55)and 98.18％(54/55),respectively.There was no significant difference in the excellent and good rate of lumbar function between the two groups(P＞0.05).No complications occurred in patients in the VBE group after surgery,while one patient in the MIS-TLIF group experienced incision exudation and delayed healing.Conclusion VBE treatment for degenerative lumbar spondylolisthesis in elderly patients shows similar efficacy with MIS-TLIF in terms of lumbar morphology,functional recovery,and safety.However,VBE can reduce tissue damage,enable earlier ambulation,and thereby accelerate the early postoperative recovery process.
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