单侧双通道内镜治疗单责任节段腰椎管狭窄症的短期临床疗效分析

目的 探讨单侧双通道内镜(unilateral biportal endoscopic, UBE)下椎管减压治疗单节段腰椎管狭窄症(lumbar spinal stenosis, LSS)的短期临床疗效。方法 回顾性分析滨州医学院附属医院2020年6月—2021年3月脊柱外科119例LSS患者的临床资料，男性57例，女性62例，年龄为(58.3±10.0)岁，病程为(19.6±9.2)个月，责任节段L_3/4 9例，L_4/5 85例，L₅/S₁ 25例。所有患者均通过UBE技术单侧入路部分椎板切除实现单侧或双侧受压神经的充分减压。比较术前、术后3个月、12个月患者腰腿痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI);比较术前、术后1个月硬膜囊面积；评价术后12个月的临床疗效(改良MacNab标准),并记录手术时间、术中出血量及并发症情况。结果 手术均顺利完成，术中出血量为(15.3±10.0)mL,手术时间为(75.2±31.2)min,术后住院时间为(6.7±1.6)d,随访(14....

Short-term clinical effect analysis of unilateral biportal endoscopic surgery for of single responsible segment lumbar spinal stenosis

  Objective  To investigate the short-term clinical effect of spinal canal decompression under Unilateral Biportal Endoscopy (UBE) in the treatment of single-segment lumbar spinal stenosis (LSS).  Methods  The clinical data of 119 patients with LSS in spine surgery from June 2020 to March 2021 in the Affiliated Hospital of Binzhou Medical University were analyzed retrospectively. There were 57 males and 62 females, with an average age of (58.3±10.0) years, a course of disease of (19.6±9.2) months, segmental L_3/4 9 cases, L_4/5 85 cases and L₅/S₁ 25 cases. All patients underwent partial laminectomy through unilateral approach with UBE technology to achieve full decompression of unilateral or bilateral compressed nerves. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared before operation, 3 months and 1 year after operation. The area of dural sac was compared before and 1 month after operation. The clinical efficacy (modified MacNab standard) at 1 year after operation was evaluated, and the operation time, intraoperative blood loss and complications were recorded.  Results  All operations were successfully completed. The intraoperative blood loss was (15.3±10.0) mL, the operation time was (75.2±31.2) min, the postoperative hospital stay was (6.7±1.6) days, and the follow-up time was (14.5±1.4) months. There were 1 case of dural sac tear and 2 cases of epidural hematoma after operation. The dural sac area was significantly improved (129.6±13.8) mm2 vs. (52.6±11.5) mm2, P < 0.05] one month after operation. The VAS score and ODI were significantly improved at 3 months and 12 months after operation (all P < 0.05). The clinical efficacy was excellent in 84 cases, good in 26 cases, fair in 6 cases, and poor in 3 cases. The excellent and good rate was 92.4% (110/119).  Conclusion  The UBE has definite curative effect, less trauma, convenient operation and rapid postoperative recovery in the treatment of single responsible segmental LSS.