Unilateral Biportal Endoscopic Lumbar Discectomy and Percutaneous Transforaminal Endoscopic Lumbar Discectomy for the Treatment of Lumbar Disc Herniation

作者：付海祥^*

北大医疗潞安医院脊柱外科

^*通信作者：付海祥，单位：北大医疗潞安医院脊柱外科，山西长治

环球医学进展, 2023, 2(1), 30-36; https://doi.org/10.12414/glmedp.240117

提交日期 : 2023年02月23日丨录用日期 : 2023年05月18日丨出版日期 : 2023年06月15日

课题资助：自筹经费，无利益冲突需要说明

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摘要：

探讨经皮椎间孔镜腰椎间盘切除技术(percutaneous endoscopic lumbar discectomy, PELD)与单侧双通道脊柱内镜技术（Unilateral Biportal Endoscopy Technique, UBE）治疗腰椎间盘突出症(lumbar disc herniation, LDH)的临床效果。方法：2020年9月-2022年1月我院手术治疗LDH患者22例，年龄为36-68岁。其中单纯腰椎间盘突出12例，伴有腰椎管狭窄10例。所有患者随机采用PELD或UBE技术进行手术。采用JOA（日本骨科学会）腰背痛疾病治疗成绩标准评分对患者进行评估。对比患者术前、术后1天、术后12个月JOA评分的差异。结果：22例患者全部顺利完成手术，无严重并发症。随访时间为13±3个月。随访发现，A组JOA评分行配对t检验有显著性差异(t=-12.894，P=0.000)。B组JOA评分行配对t检验有显著性差异(t=-9.095，P=0.000)。两组间JOA改善指数行独立样本t检验，发现差异无统计学意义(t=-1.269，P=0.219)。而伴腰椎管狭窄患者的JOA改善指数进行组间独立样本t检验，发现差异有统计学意义(t=-2.887，P=0.020)。结论：PELD与UBE技术均有效治疗LDH。UBE技术治疗LDH伴腰椎管狭窄更有效果。

关键字：经皮椎间孔镜腰椎间盘切除术；单侧双通道脊柱内镜技术；腰椎间盘突出症

Abstract：

Objective To explore percutaneous endoscopic lumbar discectomy (PELD) and Unilateral Biportal Endoscopy Technique. The clinical effect of UBE in the treatment of lumbar disc herniation (LDH). Methods: From September 2020 to January 2022, 22 LDH patients aged 36-68 years old were treated by surgery in our hospital. There were 12 cases of simple lumbar disc herniation and 10 cases of lumbar spinal stenosis. All patients were randomized to either PELD or UBE. The patients were evaluated using the JOA (Japanese Orthopaedic Society) achievement standard score for low back pain. The differences of JOA scores before surgery, 1 day after surgery and 12 months after surgery were compared. Results: All the 22 patients successfully completed the operation without serious complications. The follow-up time was 13±3 months. The follow-up showed that there were significant differences in the paired T-test of JOA branches in group A (t=-12.894, P=0.000). There were significant differences in the paired T-test of JOA scores in group B (t=-9.095, P=0.000). The JOA improvement index between the two groups was tested by independent sample t test, and the difference was not statistically significant (t=-1.269, P=0.219). The JOA improvement index of patients with lumbar spinal stenosis was statistically significant by inter-group independent sample t test (t=-2.887, P=0.020). Conclusion: Both PELD and UBE are effective in treating LDH. UBE technique is more effective in the treatment of LDH with lumbar stenosis.

Keywords:Percutaneous endoscopic lumbar discectomy; Unilateral two-channel spinal endoscopy; Lumbar disc herniation

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