腰椎退行性病双通道内镜与开放椎间融合比较
Biportal endoscopic lumbar interbody fusion versus open counterpart for lumbar degenerative diseases
慈吉辰 1汲长蛟 2张建新 3孔鹏 2翟钰泽 1宫宸 1孙昌宇 1申素昊 1牟海波1
作者信息
- 1. 山东中医药大学第一临床医学院,山东济南 250000
- 2. 山东中医药大学附属医院微创骨科,山东济南 250000
- 3. 山东中医药大学第一临床医学院,山东济南 250000;山东中医药大学附属医院微创骨科,山东济南 250000
- 折叠
摘要
[目的]比较双通道脊柱内镜下椎间融合术(biportal endoscopic lumbar interbody fusion,BE-LIF)与传统半椎板切除腰椎椎间融合术(hemilamiectomy and lumbar interbody fusion,HL-LIF)治疗腰椎退行性疾病的临床疗效.[方法]回顾性分析2022年3月—2022年11月在本院手术治疗的腰椎退行性疾病78例患者的临床资料.按照医患沟通结果,35例采用BE-LIF,41例采用HL-LIF.比较两组围手术期、随访及辅助检查等资料.[结果]虽然BE-LIF组手术时间显著长于HL-LIF组,但 BE-LIF 组切 口长度[(7.1±1.0)cm vs(11.5±2.2)cm,P＜0.001]、术中失血量[(240.0±121.2)ml vs(344.9±140.9)ml,P＜0.001]、下地时间[(3.2±0.5)d vs(4.4±0.5)d,P＜0.001]均显著优于HL-LIF组.平均随访时间(15.8±2.3)个月,随时间推移,两组的VAS、ODI、JOA 评分均显著改善(P＜0.05).术后 5 个月时,BE-LIF 组的腰痛 VAS[(1.4±0.5)vs(1.8±0.7),P=0.005]、ODI[(15.3±2.5)vs(16.7±3.2),P=0.039]、JOA 评分[(25.3±1.0)vs(24.2±1.5),P＜0.001]均显著优于 HL-LIF 组.影像方面,两组术后椎间隙高度、腰椎前凸角度均较术前显著增加(P＜0.05).各时间点两组椎间隙高度、腰椎前凸角、椎间融合Bridwell等级的差异无统计学意义(P＞0.05).[结论]两种术式均取得良好的临床疗效.BE-LIF较HL-LIF手术创伤小,术后早期腰部疼痛轻,功能恢复速度快.
Abstract
[Objective]To compare clinical efficacy of biportal endoscopic lumbar interbody fusion(BE-LIF)versus conventional hemi-lamiectomy lumbar interbody fusion(HL-LIF)for degenerative lumbar diseases.[Methods]A retrospective study was done on 78 patients who received surgical treatment for lumbar degenerative diseases in our hospital from March 2022 to November 2022.According to the re-sults of doctor-patient discussion,35 patients received BE-LIF,while other 41 patients underwent HL-LIF.The perioperative period,fol-low-up and auxiliary examination were compared between the two groups.[Results]Although the BE-LIF cohort consumed significantly lon-ger operative time than the HL-LIF cohort,the former proved significantly superior to the latter in terms of incision length[(7.1±1.0)cm vs(11.5±2.2)cm,P＜0.001],intraoperative blood loss[(240.0±121.2)ml vs(344.9±140.9)ml,P＜0.001],postoperative walking time[(3.2±0.5)days vs(4.4±0.5)days,P＜0.001].With time of the follow-up lasted for(15.8±2.3)months in a mean,the VAS,ODI and JOA scores in both groups significantly improved(P＜0.05).The BE-LIF group was significantly better than the HL-LIF group in terms of low back pain VAS[(1.4±0.5)vs(1.8±0.7),P=0.005],ODI[(15.3±2.5)vs(16.7±3.2),P=0.039]and JOA score[(25.3±1.0)vs(24.2±1.5),P＜0.001]5 months af-ter surgery.As for imaging,the intervertebral space height and the lumbar lordosis were significantly increased in both groups after surgery(P＜0.05).However,there were no significant differences in intervertebral space height,lumbar lordosis and intervertebral fusion Bridwell grade between the two groups at any time points accordingly(P＞0.05).[Conclusion]Both of the lumbar fusion methods achieved good clini-cal outcomes.By comparison,the BE-LIF takes advantage of minimally invasive surgery,with less pain in early stage after operation and faster function recovery over the HL-LIF.
关键词
腰椎退行性疾病/双通道脊柱内镜下椎间融合术/半椎板切除腰椎椎间融合术Key words
lumbar degenerative disease/biportal endoscopic lumbar interbody fusion(BE-LIF)/hemilamiectomy lumbar interbody fusion(HL-LIF)引用本文复制引用
出版年
2024
NETL
NSTL
万方数据