两种内镜腰椎间盘切除术近期结果比较

Comparison of short-term clinical outcomes of two endoscopic discectomies

[目的]对比单边双通道内镜(unilateral biportal endoscopy,UBE)和经皮内镜腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)治疗腰椎间盘突出症的临床效果。[方法]2020年6月-2020年12月,对64例单节段腰椎间盘突出患者行微创手术治疗,其中,32例采用UBE术,32例采用PELD术。比较两组患者近期临床效果。[结果]两组患者均顺利完成手术,均无血管、神经损伤等严重并发症。UBE组手术时间、平均住院日均长于PELD组,差异具有统计学意义(P<0.05).患者均获得随访6个月以上,术后随着时间的推移,两组患者VAS和ODI评分均显著下降(P<0.05)。术后1个月UBE组VAS评分显著高于PELD组(P<0.05)。相应时间点,两组间ODI指数的差异均无统计学意义(P>0.05)。与术前相比,术后两组椎管面积均显著增大(P<0.05),但相应时间点两组间椎管面积的差异均无统计学意义(P>0.05)。[结论]UBE与PELD在腰椎间盘突出的治疗上均具有良好的手术效果,但UBE手术时间、平均住院日较长。

[Objective]To compare the short-term clinical outcomes of unilateral biportal endoscopic(UBE)discectomy versus percutaneous endoscopic lumbar discectomy(PELD)for lumbar disc herniation.[Methods]From June 2020 to December 2020,a total of 64 patients received minimally invasive surgeries for single-segment lumbar disc herniation.Of them,32 patients underwent the UBE,while the remaining 32 patients were treated with PELD.The clinical outcomes in short-term were compared between the two groups.[Results]All the patients in both groups had operation completed successfully,without serious complications,such as vascular and nerve injuries.The UBE group was significantly inferior to the PELD group in operation time and hospital stay(P<0.05).All patients were followed up for more than 6 months.The VAS and ODI scores in both groups decreased significantly over time postoperatively(P<0.05).The UBE group had significantly higher VAS score than the PELD group at one month after operation(P<0.05),but which became not statistically significant at the latest follow-up(P>0.05).At any corresponding time point,there was no a significant difference in ODI index between the two groups(P<0.05).Compared with that preoperatively,the spinal canal area in the two groups increased significantly postoperatively(P<0.05),however,there was no a statistical significance in the spinal canal area between the two groups at any corresponding time point(P>0.05).[Conclusion]Both UBE and PELD are effective for treatment of lumbar disc herniation,by contrast,the UBE has longer operation time and hospital stay.