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投稿时间：2024-01-12 网络发布日期：2024-05-20
投稿时间：2024-01-12 网络发布日期：2024-05-20
中文摘要: 目的 比较单侧双通道脊柱内镜腰椎融合术（unilateral biportal endoscopic lumbar interbody fusion, ULIF）与微创通道下椎间孔入路腰椎椎间融合术（minimally invasive surgery transforaminal lumbar interbody fusion, MIS-TLIF）治疗腰椎管狭窄症的短期疗效。 方法 回顾分析合肥京东方医院2020年4月至2022年6月87 例腰椎管狭窄症患者的临床资料。其中，采用ULIF治疗43例（ULIF组），MIS-TLIF 治疗44例（MIS-TLIF组）。比较两组手术时间、术中出血量、术后卧床时间、引流管拔除时间、住院时间，术后并发症发生情况，腰、腿痛VAS评分以及Oswestry功能障碍指数（ODI）。结果 与MIS-TLIF组相比， ULIF组手术时间较长，差异有统计学意义（P<0.05）。患者术中出血量、术后卧床时间、引流管拔除时间及住院时间差异无统计学意义（P＞0.05）。术后ULIF组、MIS-TLIF组分别有2、1例发生脑脊液漏，无其他并发症发生，两组并发症发生率差异无统计学意义（P＞0.05）。两组患者均获随访12个月。ULIF组术后6个月（81.4% vs 59.1%, χ2=5.163, P＜0.05）及12个月（90.7% vs 68.2%, χ2=6.179, P＜0.05）椎间融合率显著高于MIS-TLIF组。结论 对于腰椎管狭窄症患者，ULIF能获得与MIS TLIF相似的疗效，且具有减压效率更高、手术器械操作灵活、椎间隙处理更彻底等优势，但其手术时间较长。、
Abstract:Objective To compare the short-term efficacy of unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar spinal stenosis.Methods Clinical data of 87 patients with lumbar spinal stenosis from April 2020 to June 2022 were retrospectively analyzed. Among them, 43 cases were treated with ULIF (ULIF group) and 44 cases were treated with MIS-TLIF (MIS-TLIF group). The surgical time, intraoperative blood loss, postoperative ambulation time, drainage tube removal time, hospital stay, postoperative complications, visual analog scale (VAS) scores for back and leg pain, as well as Oswestry disability index (ODI) were compared between the two groups.Results Compared with the MIS-TLIF group, the ULIF group had a longer surgical time, with statistically significant difference (P＜0.05). There was no significant difference in intraoperative blood loss, postoperative ambulation time, drainage tube removal time and hospital stay between the two groups (P＞0.05). Two cases in the ULIF group and one case in the MIS-TLIF group experienced cerebrospinal fluid leakage postoperatively, but there were no other complications in either group. There was no statistically significant difference in the incidence of complications between the two groups (P＞0.05). Both groups were followed up for 12 months. The fusion rate in the ULIF group was significantly higher than that in the MIS-TLIF group at 6 months (81.4% vs 59.1%, χ2=5.163, P＜0.05) and 12 months (90.7% vs 68.2%, χ2=6.179, P＜0.05) after surgery.Conclusion For patients with lumbar spinal stenosis, ULIF can achieve similar efficacy to MIS-TLIF, while providing higher decompression efficiency, greater surgical instrument flexibility, and more thorough intervertebral space treatment. However, ULIF has a longer surgical time.
keywords: Lumbar spinal stenosis Lumbar interbody fusion Unilateral biportal endoscopic lumbar interbody fusion Minimally invasive surgery transforaminal lumbar interbody fusion
文章编号： 中图分类号：R681.5 文献标志码：A
基金项目:
| 作者 | 单位 |
| 解正东 | 1. 合肥京东方医院骨科学部，安徽 合肥 230000 |
| 孙中仪 | 2. 同济大学附属第十人民医院骨科，上海 200001 |
| 田纪伟 | 3. 南京医科大学附属明基医院骨科，江苏 南京 210000 |
| Author Name | Affiliation |
| XIE Zhengdong*, SUN Zhongyi, TIAN Jiwei | *Department of Orthopaedics, Hefei BOE Hospital, Hefei, Anhui 230000, China |
引用文本：
解正东,孙中仪,田纪伟.单侧双通道脊柱内镜融合术与微创通道下腰椎椎间融合术对腰椎管狭窄症患者短期疗效比较[J].中国临床研究,2024,37(5):719-723.
解正东,孙中仪,田纪伟.单侧双通道脊柱内镜融合术与微创通道下腰椎椎间融合术对腰椎管狭窄症患者短期疗效比较[J].中国临床研究,2024,37(5):719-723.