Department of Orthopaedics, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Road No. 453, Hangzhou 310007, China.
Department of Orthopaedics, Hangzhou Dingqiao Hospital, Huanding Road No. 1630, Hangzhou 310021, China.
Medicina (Kaunas). 2023 Feb 23;59(3):437. doi: 10.3390/medicina59030437.
: The purpose of this study was to compare the clinical and radiological outcomes of unilateral biportal endoscopic (UBE) and percutaneous posterior endoscopic cervical discectomy (PE) keyhole surgeries. : Patients diagnosed with cervical spondylotic radiculopathy (CSR) treated by UBE or PE keyhole surgery from May 2017 to April 2020 were retrospectively analyzed. The length of incision, fluoroscopic time, postoperative hospital stay, and total cost were compared. The clinical efficacy was assessed using a visual analog scale (VAS), neck disability index (NDI), and modified MacNab criteria. Moreover, the C2-7 Cobb's angle, range of motion (ROM), intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment were measured. : A total of 154 patients were enrolled, including 89 patients in the UBE group and 65 patients in the PE group, with a follow-up period of 24-32 months. Compared with PE surgery, UBE surgery required shorter fluoroscopic times (6.76 ± 1.09 vs. 8.31 ± 1.10 s) and operation times (77.48 ± 17.37 vs. 84.92 ± 21.97 min) but led to higher total hospitalization costs and longer incisions. No significant differences were observed in the postoperative hospital stay, bleeding volume, VAS score, NDI score, effective rate, or complication rate between the UBE and PE groups. Both the C2-7 Cobb's angle and ROM increased significantly after surgery, with no significant differences between groups. There were no significant differences between intervertebral height, vertebral horizontal displacement, and angular displacement of the surgical segment at different times. : Both UBE and PE surgeries in the treatment of CSR were effective and similar after 24 months. The fluoroscopic and operation times of UBE were shorter than those of PE.
: 本研究旨在比较单侧双通道内镜(UBE)和经皮后正中内镜颈椎间盘切除术(PE)微创手术的临床和影像学结果。 : 回顾性分析了 2017 年 5 月至 2020 年 4 月采用 UBE 或 PE 微创手术治疗的颈椎病患者。比较了切口长度、透视时间、术后住院时间和总费用。采用视觉模拟评分(VAS)、颈部残疾指数(NDI)和改良 MacNab 标准评估临床疗效。此外,测量 C2-7 Cobb 角、活动度(ROM)、椎间高度、椎体水平位移和手术节段的角位移。 : 共纳入 154 例患者,UBE 组 89 例,PE 组 65 例,随访 24-32 个月。与 PE 手术相比,UBE 手术透视时间(6.76 ± 1.09 比 8.31 ± 1.10 s)和手术时间(77.48 ± 17.37 比 84.92 ± 21.97 min)更短,但总住院费用和切口更长。UBE 组和 PE 组术后住院时间、出血量、VAS 评分、NDI 评分、有效率和并发症发生率差异无统计学意义。两组术后 C2-7 Cobb 角和 ROM 均显著增加,组间差异无统计学意义。不同时间点椎间高度、椎体水平位移和手术节段的角位移无显著差异。 : CSR 患者采用 UBE 和 PE 治疗 24 个月后均有效,疗效相当。UBE 的透视时间和手术时间短于 PE。