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腰椎退变性疾病的内镜治疗:全内镜与单侧双通道内镜脊柱手术的叙述性综述

Endoscopic Treatment of Lumbar Degenerative Disc Disease: A Narrative Review of Full-Endoscopic and Unilateral Biportal Endoscopic Spine Surgery.

机构信息

Hospital Privado de Rosario, Universidad de Rosario, Rosario City, Santa Fe, Argentina.

Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

出版信息

World Neurosurg. 2024 Aug;188:e93-e107. doi: 10.1016/j.wneu.2024.05.047. Epub 2024 May 15.


DOI:10.1016/j.wneu.2024.05.047
PMID:38754549
Abstract

BACKGROUND: Degenerative lumbar spine disease is the leading cause of disability and work absenteeism worldwide. Lumbar microdiscectomy became the standard treatment for herniated discs and stenotic disease. With the evolution of different techniques, endoscopic spinal surgery emerged to minimize the surgical footprint while providing at least non-inferior results. Currently, two different types of endoscopic spine procedures are dominating the surgical scenario: "Full-Endoscopic" (FE) and Unilateral Biportal Endoscopic" (UBE) Spine Surgery. The aim of this study is to describe and analyze their indications, their technical characteristicswithitsadvantagesanddisadvantagesofbothtechniquesandtheirfuture trends. METHODS: We performed a narrative review of the most relevant articles published up to August 2023 through a Pub Med search. The search terms " FE Spine Surgery" and " UBE Spine Surgery" were used. The articles selected, were independently reviewed by 3 authors and 55 full text articles were reviewed. RESULTS: The FE and UBE Spine Surgery techniques were described. The FE technique is performed with a monoportal access under constant saline irrigation. The FE comprises the transforaminal and the interlaminar approaches, and the indication depends from the pathology to treat, and still remains controversial. UBE can approach also the spine from a posterior, postero lateral,and para spinal route. It uses two different ports addressed to a target with continuous irrigation. The process of establishing these two portals is called triangulation. CONCLUSIONS: FE and UBE spine surgery have demonstrated outcomes comparable to open surgery, minimizing complications and surgical footprint.

摘要

背景:退行性腰椎疾病是全球导致残疾和旷工的主要原因。腰椎微切除术已成为治疗椎间盘突出症和狭窄性疾病的标准治疗方法。随着不同技术的发展,内窥镜脊柱手术应运而生,在尽量减少手术创伤的同时,提供至少不劣于开放手术的效果。目前,有两种不同类型的内窥镜脊柱手术主导着手术领域:“全内窥镜”(FE)和单侧双通道内窥镜(UBE)脊柱手术。本研究旨在描述和分析它们的适应证,以及它们的技术特点及其优缺点,预测未来的发展趋势。

方法:我们通过 Pub Med 搜索,对截至 2023 年 8 月发表的最相关文章进行了叙述性综述。使用的搜索词是“FE 脊柱手术”和“UBE 脊柱手术”。选择的文章由 3 名作者独立审查,共审查了 55 篇全文文章。

结果:描述了 FE 和 UBE 脊柱手术技术。FE 技术采用单通道在持续盐水灌洗下进行。FE 包括经椎间孔和经椎板入路,适应证取决于要治疗的病变,仍存在争议。UBE 还可以从后路、后外侧和脊柱旁入路对脊柱进行治疗。它使用两个不同的端口针对一个目标进行连续灌洗。建立这两个端口的过程称为三角化。

结论:FE 和 UBE 脊柱手术已经证明了与开放手术相当的结果,同时最小化了并发症和手术创伤。

相似文献

[1]
Endoscopic Treatment of Lumbar Degenerative Disc Disease: A Narrative Review of Full-Endoscopic and Unilateral Biportal Endoscopic Spine Surgery.

World Neurosurg. 2024-8

[2]
Clinical comparison of unilateral biportal endoscopic technique versus open microdiscectomy for single-level lumbar discectomy: a multicenter, retrospective analysis.

J Orthop Surg Res. 2018-1-31

[3]
Comparison of Unilateral Biportal Endoscopic Discectomy with Other Surgical Technics: A Systemic Review of Indications and Outcomes of Unilateral Biportal Endoscopic Discectomy from the Current Literature.

World Neurosurg. 2022-12

[4]
Clinical and Radiological Comparison of Unilateral Biportal Endoscopic and Percutaneous Transforaminal Endoscopic Discectomy in the Treatment of Lumbar Spinal Degenerative Disease.

Orthop Surg. 2025-4

[5]
Clinical Efficacy of Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion.

World Neurosurg. 2025-1

[6]
Unilateral Biportal Endoscopy for Lumbar Spinal Stenosis and Lumbar Disc Herniation.

JBJS Essent Surg Tech. 2023-6-27

[7]
Unilateral biportal endoscopic versus uniportal full-endoscopic for lumbar degenerative disease: A meta-analysis.

J Orthop Sci. 2024-1

[8]
Comparison of efficacy and safety between unilateral biportal endoscopic transforaminal lumbar interbody fusion versus uniportal endoscopic transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases: a systematic review and meta-analysis.

BMC Musculoskelet Disord. 2024-12-19

[9]
Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results.

Neurosurg Focus. 2017-8

[10]
Comparison of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) for symptomatic lumbar disc herniation.

Eur Spine J. 2023-2

引用本文的文献

[1]
Impact of obesity severity on postoperative outcomes and recovery progress in patients undergoing unilateral biportal endoscopy for degenerative lumbar disc herniation.

Front Surg. 2025-5-26

[2]
Unilateral biportal endoscopic versus microscopic discectomy in degenerative lumbar spinal stenosis: A prospective cohort study.

Medicine (Baltimore). 2025-5-23

[3]
One-hole split endoscopy versus unilateral biportal endoscopy for lumbar degenerative disease: a systematic review and meta-analysis of clinical outcomes and complications.

J Orthop Surg Res. 2025-2-21

[4]
[Short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery via crossing midline approach in treatment of free lumbar disc herniation].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025-1-15

[5]
Endoscopic Contralateral Transaxillary Discectomy for Recurrent Disc Herniation.

Neurospine. 2024-12

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