Department of Orthopaedics and Spine Surgery, Medicabil Hospital International, Nilufer/Bursa, Turkey.
Department of Neurosurgery, Almostaqbal Hospital, Jeddah, Saudi Arabia.
Clin Spine Surg. 2021 Jul 1;34(6):E323-E328. doi: 10.1097/BSD.0000000000001122.
Prospective clinical study.
To the authors knowledge, there are no previous prospective studies to test the feasibility of the unilateral biportal endoscopic (UBE) technique in management of lumbar canal stenosis.
The study was conducted to compare clinical results of the UBE technique with the tubular microendoscopic (TME) surgery for management of degenerative lumbar canal stenosis.
One hundred fifty-four cases of single level degenerative lumbar canal stenosis were randomly divided into 2 groups. Each group consisted of 77 cases: one group underwent UBE and the other TME. Clinical outcome was assessed periodically: early postoperative, at 1, 3, and every 6 months for 2 years. Clinical outcome assessment operatives included the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and patient satisfaction using Modified Macnab Criteria (MMC). In addition, the admission period, operative time, and estimated blood loss were compared.
In UBE cases, ODI and ZCQ were statistically superior to TME for all periods (P<0.05). For both approaches, values presented progressive improvement until the 24th month. Regarding ODI, UBE and TME had an 84% and 79% success rate, respectively. In ZCQ, UBE and TME had a 79% and 73% success rate, respectively, at the end of the 24th month. Regarding the MMC, UBE and TME had 63% and 29% excellent results, respectively. UBE also has shorter admission period (days: 1.11 vs. 1.28), operative time (minutes: 57.74 vs. 65.31), and less estimated blood loss (mL: 49.47 vs. 53.57).
Given its demanding learning curve, UBE is considered an effective alternative to TME with a higher clinical success rate.
前瞻性临床研究。
据作者所知，以前没有前瞻性研究来测试单侧双通道内镜（UBE）技术在治疗腰椎管狭窄症中的可行性。
本研究旨在比较 UBE 技术与管状显微镜（TME）手术治疗退行性腰椎管狭窄症的临床效果。
将 154 例单节段退行性腰椎管狭窄症患者随机分为 2 组，每组 77 例：一组行 UBE，另一组行 TME。定期评估临床结果：术后早期、术后 1、3、6 个月，随访 2 年。临床疗效评估包括 Oswestry 功能障碍指数（ODI）、苏黎世跛行问卷（ZCQ）和改良 Macnab 标准（MMC）评估的患者满意度。此外，还比较了住院时间、手术时间和估计失血量。
UBE 组 ODI 和 ZCQ 在所有时期均优于 TME（P<0.05）。对于两种方法，数值均呈逐渐改善，直至 24 个月。在 ODI 方面，UBE 和 TME 的成功率分别为 84%和 79%。在 ZCQ 方面，UBE 和 TME 在第 24 个月的成功率分别为 79%和 73%。关于 MMC，UBE 和 TME 的优秀率分别为 63%和 29%。UBE 还具有较短的住院时间（天：1.11 对 1.28）、手术时间（分钟：57.74 对 65.31）和较少的估计失血量（毫升：49.47 对 53.57）。
鉴于其较高的学习曲线，UBE 被认为是 TME 的有效替代方法，具有更高的临床成功率。
