单侧双通道脊柱内镜技术治疗腰椎间盘突出症的临床疗效观察

目的 观察单侧双通道脊柱内镜技术治疗腰椎间盘突出症的临床治疗效果。方法 分析2021年1月至2022年1月到荆门市中医医院骨伤一科就诊需手术治疗的腰椎间盘突出症患者共62例，随机分为观察组（31例）与对照组（31例）。观察组采用单侧双通道脊柱内镜手术治疗，对照组采用传统后入路开放手术治疗，分别记录术前和术后的腰腿痛VAS评分、ODI评分、手术时间、术中出血量、术后下地时间、住院时间、术后并发症等情况，术后末次随访评估计算有效率。结果 两组患者术后3 d、术后1个月及末次随访时的腰腿痛VAS评分及ODI评分均明显小于术前，术前术后比较差异有统计学意义（P<0.05）；观察组术中出血量、术后下地时间、住院时间均少于对照组，两组比较差异有统计学意义（P<0.05）；两组患者手术时间比较，差异无统计学意义（P>0.05）。两组患者术中均未更改手术方式，术后均未出现脑脊液漏、切口感染、神经血管损伤等并发症，均未行再次手术。末次随访时运用改良Macnab标准评价两组患者有效率，两组比较差异无统计学意义（P>0.05）。结论 单侧双通道脊柱内镜技术治疗腰椎间盘突出症的临床疗效...

Clinical effect of unilateral biportal endoscopy in the treatment of lumbar disc herniation

Objective To observe the clinical effect of unilateral biportal endoscopy (UBE) in the treatment of lumbar disc herniation.Methods From January 2021 to January 2022, 62 patients with lumbar disc herniation who needed surgical treatment in the Department of Orthopedics and Traumatology of Jingmen Hospital of Traditional Chinese Medicine were analyzed. They were randomly divided into study group (31 cases) and control group (31 cases). Then, the study group was treated with unilateral biportal endoscopy, while the control group was treated with traditional open approach spinal instrumentation. The VAS scores and ODI scores of low back and leg pains before and after operation; the operation time, intraoperative blood loss, postoperative ambulation time, hospital stay and postoperative complications of the two groups were recorded respectively, and the efficacy rate was evaluated at the final follow-up after operation.Results The VAS scores and ODI scores of low back and leg pains of the two groups on the 3^rd day, 30^th day and the day of final follow-up after the operation were significantly lower than those before the operation, which was of statistical significance (P<0.05). The intraoperative blood loss, postoperative ambulation time and hospital stay of the study group were less than those of the control group, and the difference was of statistical significance (P<0.05). There was no statistically significant difference in surgical time between the two groups (P>0.05). Both the two groups of patients did not change the operation mode in the process of operation, there were no serious complications such as cerebrospinal fluid leakage, incision infection, and neurovascular injury were present after operation, and no secondary operation was performed. Comparison of effective rate of two groups of patients evaluated by modified Macnab standard at the last follow-up, and the difference was of no statistical significance (P>0.05).Conclusion The unilateral biportal endoscopy has accurate clinical effect in the treatment of lumbar disc herniation. Compared with traditional open approach spinal instrumentation, UBE technology has the characteristics of less trauma, rapid recovery, clear visual field, complete decompression and gentle learning curve. Therefore, it is worthy of clinical promotion and application.