单侧双通道内镜椎间盘切除术的初步结果

Preliminary outcomes of unilateral biportal endoscopic discectomy

[目的]探讨单侧双通道内镜技术治疗腰椎间盘突出症的疗效和安全性。[方法]2020年1月—2020年8月,作者采用UBE技术治疗腰椎间盘突出症36例,其中,男23例,女13例;平均年龄(39.30±13.90)岁,病变节段位于L3/41例,L4/518例,L5S117例。评价临床与影像结果。[结果]所有患者顺利完成手术,平均手术时间(89.19±35.20)min,术后引流量(19.25±15.90)ml,住院时间(3.53±2.14)d。除1例患者术中神经根损伤,但未引起严重不良后果外,其余患者均无术中并发症。随访时间(4.30±1.23)个月,术后VAS评分、Oswestry指数均较术前显著改善(P<0.05)。按改良Macnab标准,临床结果优良率为91.67%。影像方面,末次随访MRI显示椎间隙高度较术前显著降低(P<0.05),椎管面积较术前显著增加(P<0.05)。[结论]单侧双通道技术具有相对易于掌握的优点,是治疗腰椎间盘突出症的安全可行方法。

[Objective]To exlpore the efficacy and safety of unilateral biportal endoscopy(UBE)in the treatment of lumbar disc herniation.[Methods]From January 2020 to August 2020,36 patients,including 23 males and 13 females aged(39.30±13.90)years on a mean,were treated by UBE technique for lumbar disc herniation involving L3/4in a case,L4/5in 18 cases and L5S1in 17 cases.The clinical and imaging consequences were evaluated.[Results]All patients had UBE discectomy completed successfully with operation time of(89.19±35.20)min,postoperative drainage volume of(19.25±15.90)ml,and hospital stay of(3.53±2.14)days.All the patients had no serious intraoperative complications,except one patient who got nerve root injury that not lead serious consequence.As time went during the follow up period lasted for(4.30±1.23)months,the low back pain and leg pain VAS scores,as well as Oswestry index significantly improved(P<0.05).According to the modified Macnab’s criteria,the excellent and good rate of clinical results was of 91.67%.Radiographically,a significant decrease of the intervertebral height,whereas a significant enlargement of spinal canal area was found at the latest follow up compared with those preoperatively(P<0.05).[Conclusion]The UBE technique has a character of relatively easy to be mastered,is a safe and feasible method for the treatment of lumbar disc herniation.