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单侧双门内镜辅助下经椎间孔腰椎椎间融合术治疗复发性腰椎间盘突出症的病例系列

Case series of unilateral biportal endoscopic-assisted transforaminal lumbar interbody fusion in the treatment of recurrent lumbar disc herniation.

作者信息

Gao Xiangcheng, Gao Lin, Chang Zhen, Hao Dingjun, Du Jinpeng, Wu Jiayuan, Zhao Zhigang, Yang Xiaobin, Hui Hua, He Baorong, Yan Liang

机构信息

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University Xi'an, China.

School of Medicine, Yan'an University Yan'an 716000, China.

出版信息

Am J Transl Res. 2022 Apr 15;14(4):2383-2392. eCollection 2022.

Abstract

OBJECTIVE

To explore the clinical effect of unilateral biportal endoscopic-assisted transforaminal lumbar interbody fusion (UBE-TLIF) in the treatment of recurrent lumbar disc herniation (RLDH).

METHODS

The clinical data of 44 patients with RLDH treated by UBE-TLIF in our hospital from August 2020 to December 2020 were analysed retrospectively. The study indicators included intraoperative blood loss, operation time, bed rest time, and hospital stay. The follow-up data included the visual analogue score (VAS) of low back pain, Japanese Orthopaedic Association score (JOA), Oswestry disability index (ODI) score, and the short form 36 health survey questionnaire (SF-36) score preoperatively and 1 week and 6 months postoperatively.

RESULTS

The average operation time was 179.15 ± 42.06 minutes, the average intraoperative blood loss was 132.67 ± 41.92 ml, the average bed rest time was 1.51 ± 0.42 days, and the average hospital stay was 4.82 ± 1.13 days. The VAS score of low back pain after the operation was lower than that before the operation (all P<0.0001). The ODI score, JOA score, and SF-36 scores at postoperative follow-up were significantly different from those before the operation (P<0.05). The satisfaction rate was 86.4% at 7 days after the operation and 95.4% at 6 months after the operation. The proportion of significant clinical efficacy was 18.2% (postoperative day 7) and 63.6% (postoperative month 6).

CONCLUSIONS

UBE-TLIF has the advantages of a rapid recovery, less intraoperative blood loss, a short bed rest and hospital stay, and a good medium-term clinical effect. It is a safe, reliable minimally invasive technique for surgical treatment of RLDH.

摘要

目的

探讨单侧双通道内镜辅助下经椎间孔腰椎椎间融合术(UBE-TLIF)治疗复发性腰椎间盘突出症(RLDH)的临床效果。

方法

回顾性分析2020年8月至2020年12月在我院接受UBE-TLIF治疗的44例RLDH患者的临床资料。研究指标包括术中出血量、手术时间、卧床时间和住院时间。随访数据包括术前、术后1周和6个月时的腰痛视觉模拟评分(VAS)、日本骨科协会评分(JOA)、Oswestry功能障碍指数(ODI)评分以及简短健康调查36项问卷(SF-36)评分。

结果

平均手术时间为179.15±42.06分钟,平均术中出血量为132.67±41.92毫升,平均卧床时间为1.51±0.42天,平均住院时间为4.82±1.13天。术后腰痛VAS评分低于术前(均P<0.0001)。术后随访时的ODI评分、JOA评分和SF-36评分与术前相比有显著差异(P<0.05)。术后7天的满意率为86.4%,术后6个月为95.4%。显著临床疗效的比例在术后第7天为18.2%,术后第6个月为63.6%。

结论

UBE-TLIF具有恢复快、术中出血少、卧床和住院时间短以及中期临床效果良好的优点。它是一种安全、可靠的微创技术,用于RLDH的手术治疗。

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