单侧双通道内镜下腰椎椎间融合术与内镜下腰椎椎间融合术治疗腰椎退行性疾病的临床疗效与安全性的Meta分析
Meta-Analysis of the Clinical Efficacy and Safety of Unilateral Biportal Endoscopic Lumbar Interbody Fusion versus Endoscopic Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases.
作者信息
Li Xiangxuan, Qu Yiming, Zhou Liang, Zhou Yanjie, Peng Bin, Duo Jizeren
机构信息
Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Chongqing City, China.
Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Chongqing City, China.
出版信息
World Neurosurg. 2025 Mar;195:123662. doi: 10.1016/j.wneu.2025.123662. Epub 2025 Feb 18.
OBJECTIVE
To compare the efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and endoscopic lumbar interbody fusion (Endo-LIF) in the treatment of lumbar degenerative diseases.
METHODS
A thorough literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the PICO framework (PROSPERO 2024CRD42024592073). The databases searched included PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database, with a time frame of January 2020 to June 2024. Outcome metrics included operative time, rate of progress of surgical time for beginners, intraoperative bleeding, hidden blood loss, total blood loss (TBL), postoperative drainage, hospitalization time, visual analog score for pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates.
RESULTS
A total of 10 papers were included, including two that were randomized controlled trials. This study involved 710 patients, 348 in the UBE-LIF group and 362 in the Endo-LIF group. The results showed that the UBE-LIF group was superior to the Endo-LIF group in terms of operative time and rate of progress of surgical time for beginners. In contrast, the Endo-LIF group was superior to the UBE-LIF group in terms of hospitalization time, hidden blood loss, and TBL. There were no statistical differences between the two procedures regarding intraoperative bleeding, postoperative drainage, visual analog score for low back pain, Oswestry Disability Index, complications, fusion rates, and modified MacNab score excellence rates.
CONCLUSIONS
Postoperative pain and safety were comparable between the two endoscopic procedures.The UBE-LIF procedure was shorter, whereas the Endo-LIF had less TBL and a shorter recovery time.
目的
比较单侧双通道内镜下腰椎椎间融合术（UBE-LIF）与内镜下腰椎椎间融合术（Endo-LIF）治疗腰椎退行性疾病的疗效和安全性。
方法
根据系统评价和Meta分析的首选报告项目指南及PICO框架（PROSPERO 2024CRD42024592073）进行全面的文献检索。检索的数据库包括PubMed、Embase、科学网、Cochrane图书馆、中国知网和万方数据库，时间范围为2020年1月至2024年6月。结局指标包括手术时间、初学者手术时间进展率、术中出血、隐性失血、总失血量（TBL）、术后引流量、住院时间、视觉模拟疼痛评分、Oswestry功能障碍指数、并发症、融合率和改良MacNab评分优良率。
结果
共纳入10篇论文，其中2篇为随机对照试验。本研究涉及710例患者，UBE-LIF组348例，Endo-LIF组362例。结果显示，UBE-LIF组在手术时间和初学者手术时间进展率方面优于Endo-LIF组。相比之下，Endo-LIF组在住院时间、隐性失血和TBL方面优于UBE-LIF组。两种手术在术中出血、术后引流量、下腰痛视觉模拟评分、Oswestry功能障碍指数、并发症、融合率和改良MacNab评分优良率方面无统计学差异。
结论
两种内镜手术的术后疼痛和安全性相当。UBE-LIF手术时间较短，而Endo-LIF的TBL较少且恢复时间较短。
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