Clinical efficacy of transforaminal lumbar interbody fusion of 36 cases under unilateral biportal en-doscopy
Objective To evaluate the clinical efficacy of transforaminal lumbar interbody fusion under unilateral biportal endoscopy(UBE)in the treatment of lumbar degenerative diseases.Methods In total,85 patients with lumbar degenerative diseases were selected in the Second Affiliated Hospital of Zhengzhou University from March 2021 to December 2023.A total of 36 cases in the UBE group were trea-ted with unilateral biportal endoscopic lumbar decompression,percutaneous fixation,transforaminal lumbar interbody fusion with bone graft.The rest 49 cases in the open group were treated with traditional lumbar decompression and fixation and interbody fusion.There were 40 males and 45 females,aged from 52 to 74 years with an average of 62.3 years.The surgical related indicators(surgical time,intraoperative bleed-ing volume,postoperative drainage volume,length of hospital stay,incidence of complications),serologi-cal indicators(creatine kinase,C-reactive protein),and clinical efficacy evaluation(VAS score for preop-erative and postoperative pain,JOA score for lower back pain efficacy,and lumbar fusion rate)were com-pared between two groups.T test andX2 test were used to compare the measurement data between groups.Results The patients were followed up for 4-12 months(mean 7.4±3.2 months).The surgical time,intraoperative bleeding volume,postoperative drainage volume and length of hospital stay in UBE group were significantly reduced as compared with those in open surgery group[UBE group:(127.14±25.25)min,(132.78±47.43)ml,(37.54±10.62)ml,(7.42±0.77)d;open surgery group:(164.17±26.12)min,(280.61±47.67)ml,(50.19±22.35)ml,(10.71±1.73)d,t=7.549,-14.169,7.904,-10.663,P＜0.05].The levels of creatine kinase and C-reactive protein in the UBE group were significantly lower than those in the open surgery group on the 1st and 3rd day after operation[UBE group:(178.02±67.34)U/L,(93.46±35.27)U/L,(20.25±15.34)mg/L,(17.64±13.32)mg/L;open surgery group:(296.22±94.76)U/L,(152.43±40.51)U/L,(31.82±27.53)mg/L,(24.67±17.24)mg/L,t=-10.287,-9.528,-7.861,-8.982,P＜0.05].There was no significant differ-ence between the two groups in the incidence of complications,VAS score for preoperative and postopera-tive pain,JOA score for lower back pain efficacy,level of creatine kinase,C-reactive protein on the 7th day after operation,lumbar fusion rate(P＞0.05).In the UBE group,one case had nerve root injury.Conclusion Unilateral biportal endoscopic transforaminal lumbar interbody fusion is an effective method for the treatment of lumbar degenerative diseases with the advantages of less operative trauma,less blood loss and quicker postoperative recovery.
NETL
NSTL
万方数据
