单边双通道脊柱内镜技术治疗高度游离椎间盘突出的疗效观察

目的观察单边双通道脊柱内镜技术(UBE)治疗游离型椎间盘突出的临床疗效.方法高度游离椎间盘突出症患者38例随机分为观察组和对照组.观察组20例行UBE治疗,对照组18例行经板间入路腰椎间盘髓核摘除术(PEID).比较两种术式的手术时间,患者术中出血量、术后伤口愈合和术后并发症发生情况,术前、术后1个月及3个月随访患者的腰腿痛VAS评分及ODI指数.结果UBE与PEID治疗高度游离椎间盘突出的临床效果相仿.术后伤口愈合均良好,无明显并发症发生.两组患者的腰腿痛VAS评分及ODI指数比较,差异无统计学意义(P>0.05).结论单边双通道内镜技术的术野更广,观察通道不受管道限制,神经探查和松解便捷,是治疗高度游离椎间盘的上佳选择.

Objective To observe the clinical effect of unilateral dual-channel endoscopy(UBE)in the treatment of free-type intervertebral disc herniation.Methods Thirty-eight patients with high free intervertebral disc herniation were mndomly divided into observarion group and control group.Twenty patients in the observation group underwent UBE treatment,and 18 patients in the control group underwent lumbar discectomy(PEID)through the interlaminar approach.The operation time of the two surgical methods,the amount of blood loss,postoperative wound healing,the occurrence of postoperative complications,and the VAS score and ODI index of the patienLs with low back pain were compared before operation,1 month and 3 months after operation.Results UBE and PEID had similar clinical effects in the treatment of high-free intervertebral disc herniation.The wounds healed well after operation,and no obvious complications occurred.There was no significant difference in the VAS score and ODI index of low back and leg pain between the two groups(P>0.05).Conclusion The single-sided dual-channel endoscopy technology has a wider surgical field,the observation channel is not restricted by the pipeline,and the nerve exploration and release are convenient.It is the best choice for the treatment of highly free intervertebral discs.