内镜下单侧椎板切开双侧减压技术治疗脊柱退行性疾病的研究进展

Research progress of endoscopic unilateral laminectomy for bilateral decompression in the treatment of spinal degenerative diseases

近年来,单侧椎板切开双侧减压(unilateral laminotomy for bilateral decompression,ULBD)技术在脊柱外科领域已经成为一种新兴的手术技术,得到越来越多研究者的认可。内镜辅助下行ULBD技术,术中可以获得更加清晰的视野而避免损伤硬膜囊及神经根,在保留脊柱的生理解剖结构的同时增大了术后脊柱稳定性,提高患者满意度及生活质量。该技术要求术者对解剖结构、手术步骤及器械有足够的认知,所以陡峭的学习曲线已然是该技术的一个难点。本文针对内镜下ULBD技术的发展历史、临床应用、应用前景,以及适应证、禁忌证和并发症等多个方面进行综述。

In recent years,the unilateral laminotomy for bilateral decompression(ULBD)has become a new surgical technique in the field of spinal surgery,which has been increasingly recognized.Endoscopic ULBD favors a clearer field of view during the operation to avoid damages to the dural sac and nerve roots.It preserves the physiological and anatomical structure of the spine,and improve the postoperative spinal stability,satisfaction and quality of life.The steep learning curve is challenging for ULBD,which requires the surgeon to have a good understanding of the anatomy,procedures,and instruments.This article reviews the development history,clinical application,application prospect,indications,contraindications and complications of endoscopic ULBD.