Han Shuo, Zeng Xiangxu, Zhu Kai, Wu Xiaoqi, Shen Yanqing, Han Jialuo, Lin Antao, Meng Shengwei, Zhang Hao, Li Guanghui, Liu Xiaojie, Tao Hao, Ma Xuexiao, Zhou Chuanli
Department of Spine Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Spine Surgery, Linqu Hospital of Qingdao University Medical Group, Weifang, China.
Pain Ther. 2022 Dec;11(4):1309-1326. doi: 10.1007/s40122-022-00428-3. Epub 2022 Sep 3.
Recently, large channel endoscopic systems and full endoscopic visualization technique have been used to perform unilateral laminotomy for bilateral decompression (ULBD) treatment for lumbar central spinal stenosis (LCSS). However, various endoscopic systems possess different design parameters, which may affect the technical points and treatment outcomes. The object of this retrospective study was to compare the efficiency, safety, and effectiveness of ULBD under the iLESSYS Delta system versus the Endo-Surgi Plus system.
In the period from October 2020 to April 2021, ULBD was performed using the iLESSYS Delta system or Endo-Surgi Plus system to treat LCSS. Patients were classified into two groups based on the endoscopy system employed. Patient demographics, perioperative indexes, complications, and imaging characteristics were reviewed. Clinical outcomes were quantified using back and leg visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at the time points of follow-up.
Thirty-two patients were assigned to the iLESSYS Delta system group and 37 to the Endo-Surgi Plus system group. In the comparison between the two groups, the Endo-Surgi Plus system possessed a shorter incision length and operation time (p < 0.005), and no statistical differences in other aspects were observed. The dural sacs of both groups were significantly expanded postoperatively compared to preoperatively (p < 0.001). Both groups experienced improvements in VAS and ODI scores at all time points (p < 0.001) and equally low frequency of complications.
Current research suggests that both the Endo-Surgi Plus system and iLESSYS Delta system achieved favorable high safety and clinical outcomes in ULBD for treatment of LCSS. The use of a fully visualized trephine may have increased the efficiency of the Endo-Surgi Plus system. Moreover, the Endo-Surgi Plus system may be associated with a wider decompression range and indications.
最近，大通道内镜系统和全内镜可视化技术已被用于对腰椎中央管狭窄症（LCSS）进行单侧椎板切开双侧减压（ULBD）治疗。然而，各种内镜系统具有不同的设计参数，这可能会影响技术要点和治疗效果。本回顾性研究的目的是比较iLESSYS Delta系统与Endo-Surgi Plus系统下ULBD的效率、安全性和有效性。
在2020年10月至2021年4月期间，使用iLESSYS Delta系统或Endo-Surgi Plus系统对LCSS患者进行ULBD治疗。根据所采用的内镜系统将患者分为两组。回顾患者的人口统计学资料、围手术期指标、并发症和影像学特征。在随访时间点，使用背部和腿部视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）对临床结果进行量化。
32例患者被分配到iLESSYS Delta系统组，37例被分配到Endo-Surgi Plus系统组。两组比较中，Endo-Surgi Plus系统的切口长度和手术时间较短（p < 0.005），在其他方面未观察到统计学差异。与术前相比，两组的硬膜囊术后均明显扩大（p < 0.001）。两组在所有时间点的VAS和ODI评分均有改善（p < 0.001），且并发症发生率同样较低。
目前的研究表明，Endo-Surgi Plus系统和iLESSYS Delta系统在ULBD治疗LCSS方面均取得了良好的高安全性和临床效果。使用全可视化环锯可能提高了Endo-Surgi Plus系统的效率。此外，Endo-Surgi Plus系统可能具有更广泛的减压范围和适应证。
