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单侧双通道内镜下腰椎间融合术与微创治疗腰椎退变性疾病的早期疗效和安全性对比

"Early Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion Versus Minimal Invasive in the Treatment of Lumbar Degenerative Diseases".

机构信息

Bengbu Medical College, Bengbu, China.

Department of Orthopedics, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China.

出版信息

Clin Spine Surg. 2023 Oct 1;36(8):E390-E396. doi: 10.1097/BSD.0000000000001470. Epub 2023 Jun 28.

DOI:10.1097/BSD.0000000000001470
PMID:37448192
Abstract

STUDY DESIGN

This was a retrospective cohort study.

OBJECTIVE

To compare the early clinical efficacy and radiologic outcomes between unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

SUMMARY OF BACKGROUND DATA

Along with the continuous development of endoscopic technology, the early safety and effectiveness of ULIF technology are still unknown.

MATERIALS AND METHODS

This retrospective study included 61 patients who underwent fusion surgery through ULIF or MIS-TLIF in 2021. Twenty-nine patients underwent ULIF (group A), and 32 underwent MIS-TLIF (group B). Fusion rate, bone graft volume, hidden blood loss (HBL), C-reactive protein level, operative time, Oswestry Disability Index , Visual Analog Scale score, and MacNab criteria were assessed in both groups.

RESULTS

The Visual Analog Scale score for back pain in the early postoperative period was significantly lower in group A than in group B ( P <0.05). All other clinical scores showed improvement, with no significant difference between the 2 groups ( P >0.05). There was no statistically significant difference in postoperative C-reactive protein levels and fusion rates between the 2 groups ( P >0.05). However, HBL was higher and operative time was longer in group A than in group B ( P <0.05). Most importantly, there were no statistically significant differences between groups A and B in fusion rate, length of stay and bone graft volume ( P >0.05). No serious surgical complications occurred in our study.

CONCLUSIONS

ULIF is a new option for lumbar fusion. Despite the drawbacks of longer operation time and higher HBL, ULIF may be a viable alternative to MIS-TLIF as technology advances.

摘要

研究设计

这是一项回顾性队列研究。

目的

比较单侧双通道内镜下腰椎间融合术(ULIF)与微创经椎间孔腰椎间融合术(MIS-TLIF)的早期临床疗效和影像学结果。

背景资料概要

随着内镜技术的不断发展,ULIF 技术的早期安全性和有效性仍不清楚。

材料和方法

本回顾性研究纳入了 2021 年接受 ULIF 或 MIS-TLIF 融合手术的 61 例患者。29 例患者接受 ULIF(A 组),32 例患者接受 MIS-TLIF(B 组)。评估两组患者的融合率、植骨量、隐性失血(HBL)、C 反应蛋白水平、手术时间、Oswestry 功能障碍指数、视觉模拟评分和 MacNab 标准。

结果

A 组患者术后早期腰痛的视觉模拟评分明显低于 B 组(P<0.05)。所有其他临床评分均有所改善,但两组间无显著差异(P>0.05)。两组间术后 C 反应蛋白水平和融合率无统计学差异(P>0.05)。然而,A 组的 HBL 较高,手术时间较长(P<0.05)。最重要的是,A 组和 B 组在融合率、住院时间和植骨量方面无统计学差异(P>0.05)。本研究中未发生严重手术并发症。

结论

ULIF 是腰椎融合的一种新选择。尽管手术时间较长和 HBL 较高,但随着技术的进步,ULIF 可能是 MIS-TLIF 的可行替代方案。

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