单侧双通道内镜治疗复发性腰椎间盘突出症
Unilateral biportal endoscopic transforaminal lumbar interbody fusion for recurrent lumbar disc herniation
潘其鹏 1孔凡国 1付拴虎 2王文举 1张昌盛 1朱卉敏 1赵文海3
作者信息
- 1. 河南省洛阳正骨医院(河南省骨科医院)脊柱微创外科,河南郑州 450016
- 2. 广西中医药大学第一附属医院脊柱外科,广西南宁 530023
- 3. 长春中医药大学第一附属医院骨伤科,吉林长春 130021
- 折叠
摘要
[目的]评价单侧双通道内镜下经椎间孔腰椎间融合术(unilateral biportal endoscopic transforaminal lumbar interbody fusion,UBE-TLIF)治疗复发性腰椎间盘突出症(recurrent lumbar disc herniation,RLDH)的临床疗效.[方法]回顾性分析2022年1月-2023年12月本院收治的38例RLDH患者的临床资料.依据术前医患沟通结果,18例行UBE-TLIF翻修术,另外20例行开放后路腰椎间融合(posterior lumbar interbody fusion,PLIF)翻修术.评价比较临床及影像资料.[结果]两组患者均顺利完成手术,无神经损伤等并发症.BE-TLIF组在手术时间[(138.3±15.4)min vs(154.8±14.6)min,P=0.002]、术中出血量[(186.1±41.0)ml vs(230.5±55.8)ml,P=0.009]、下地时间[(2.4±0.6)d vs(5.9±1.0)d,P＜0.001]、住院时间[(8.1±2.3)d vs(12.4±2.9)d,P＜0.001]均显著优于PLIF组.随访时间平均(5.4±1.1)个月,UBE-TLIF组在术后1 d腰痛VAS评分[(2.2±0.7)vs(3.1±0.8),P=0.002]、ODI 评分[(36.7±3.4)vs(57.0±3.9),P＜0.001]和 JOA 评分[(11.2±2.4)vs(9.2±2.5),P=0.018]均显著优于 PLIF 组,但是,末次随访时,两组间上述指标的差异均无统计学意义(P＞0.05).[结论]UBE-TLIF组早期功能恢复优于PLIF组,并具有手术时间短、术中出血量少、下地时间早、住院时间短等优势.
Abstract
[Objective]To evaluate the clinical outcomes of unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF)for recurrent lumbar disc herniation(RLDH).[Methods]A retrospective study was conducted on 38 patients who had RLDH treated surgically in our hospitals from January 2022 to December 2023.Based on preoperative doctor-patient communication,18 patients underwent UBE-TLIF,while other 20 patients received posterior lumbar interbody fusion(PLIF).Clinical and imaging data were evaluated and compared between the two groups.[Results]All patients in both groups were operated on successfully without neurological injury and other complications.The UBE-TLIF group proved significantly superior to the PLIF group in terms of operative time[(138.3±15.4)min vs(154.8±14.6)min,P=0.002],intraoperative blood loss[(186.1±41.0)ml vs(230.5±55.8)ml,P=0.009],the ambulation time[(2.4±0.6)days vs(5.9±1.0)days,P＜0.001],hospital stay[(8.1±2.3)days vs(12.4±2.9)days,P＜0.001].All patients in both groups were followed up for a mean of(5.42±1.10)months.The UBE-TLIF group proved significantly better than the PLIF group regarding to back pain VAS score[(2.2±0.7)vs(3.1±0.8),P=0.002],ODI score[(36.7±3.4)vs(57.0±3.9),P＜0.001]and JOA scores[(11.2±2.4)vs(9.2±2.5),P=0.018]1 day after surgery,whereas which became not statistically significant between the two groups at the latest follow-up(P＞0.05).[Conclusion]The UBE-TLIF achieves better early functional recovery,with the advantages of shorter operation time,less intraoperative blood loss,earlier ambulation time and shorter hospital stay over the PLIF.
关键词
复发性腰椎间盘突出症/翻修手术/单侧双通道内镜/经椎间孔腰椎间融合术/后路腰椎间融合术Key words
recurrent lumbar disc herniation/revision surgery/unilateral biportal endoscopy/transforaminal lumbar interbody fusion/posterior lumbar interbody fusion引用本文复制引用
基金项目
河南省中医药科学研究专项课题(2024ZY3072)
出版年
2024
NETL
NSTL
万方数据