单侧双通道内镜技术治疗腰椎间盘脱出症的临床疗效

Clinical efficacy of unilateral biportal endoscopic technique in treatment of lumbar disc herniation

目的 探讨采用单侧双通道内镜技术(Unilateral Biportal Endoscopy, UBE)治疗腰椎间盘脱出症的临床效果。方法 回顾性分析2022年7月—2023年3月某市立医院创伤中心采用单侧双通道内镜技术治疗腰椎间盘脱出症患者34例的临床资料,其中男19例,女15例,年龄19~78岁,平均52.4岁;腰椎间盘脱出节段包括L3/4 2例,L4/5 23例,L5/S1 9例,全部采取了UBE微创脱出髓核摘除手术。采用视觉模拟评分法(VAS),Oswestry功能障碍指数(ODI)进行术前后效果比较,疗效评价以MacNab标准评定。结果 34例患者均获得随访,随访时间8~17个月,平均12.4个月,患者术后3个月ODI指数为(7.88±3.97)%、末次随访的ODI指数为(1.76±1.69)%,均较术前的(61.24±13.40)%明显改善,差异有统计学意义(P<0.05);VAS评分术后1周为(1.50±0.66)分、术后3个月为(0.68±0.54)分、末次随访为(0.21±0.41)分,均较术前的(6.12±0.97)分明显改善,差异有统计学意义(P<0.05)。末次随访时MacNab标准:优25例、良8例、可1例,优良率为97.06%,未见复发病例。结论 采用UBE手术治疗腰椎间盘脱出症具有临床效果确切,手术创伤小,患者恢复快,值得临床推广。

Objective To explore the clinical effect of unilateral biportal endoscopic(UBE)technique in the treatment of lumbar disc herniation.Methods 34 patients suffering from lumbar disc herniation who were treated with unilateral dual channel endoscopic technique in Trauma Center of Anqing Municipal Hospital from July 2022 to March 2023 were enrolled as the study subjects,including 19 males and 15 females,aged 19-78 years,with an average age of 52.4 years.Herniated lumbar disc segments included 2 cases of L3/4,23 cases of L4/5,and 9 cases of L5/S1,all of which underwent UBE minimally invasive nucleus pulposus extraction surgery.Visual Analog Scale(VAS)and Oswestry Dysfunction Index(ODI)were used to compare the effects before and after surgery,and the efficacy was evaluated by using the MacNab standard.Results All the 34 patients were got followed up,and the follow up time were 8-17 months,with an average time of 12.4 months.The ODI index at 3 months post surgery(7.88±3.97)%and the ODI index at the last follow-up(1.76±1.69)%were significantly improved compared to preoperative(61.24±13.40)%,and the difference was statistically significant(P<0.05).The VAS score improved significantly at 1 week(1.50±0.66)postoperative,3 months(0.68±0.54)postoperative,and at the last follow-up(0.21±0.41)compared to preoperative(6.12±0.97),with statistical significance(P<0.05).At the last follow-up,the MacNab criteria were excellent in 25 cases,good in 8 cases,and fair in 1 case,with an excellent and good rate of 97.06%,and no recurrence cases were found.Conclusions The use of UBE surgery for the treatment of lumbar disc herniation has definite clinical effects,minimal surgical trauma,and fast patient recovery,which is worthy of clinical promotion.