Ma Jie, Chen Fei, Zhu Zeyuan, Liao Tong, Wang Hengjun
Department of Spine and Orthopedics, Bozhou District People's Hospital, Zunyi City, Guizhou Province, 563100, China.
President of Zunyi Network Association of Guizhou Province, Guizhou Province, 563100, China.
J Orthop Surg Res. 2025 Apr 9;20(1):357. doi: 10.1186/s13018-025-05771-7.
To compare the treatment outcomes of unilateral unichannel and bichannel endoscopic Unilateral Laminotomy for Bilateral Decompression (ULBD) surgery in patients with lumbar spinal stenosis and analyze factors interfering with efficacy.
This retrospective study included a total of 122 patients diagnosed with lumbar spinal stenosis who were treated at Bozhou District People's Hospital between June 2022 and June 2024. The patients were divided into two groups based on their surgical procedure: the unichannel endoscopic ULBD group (n = 61) and the bichannel endoscopic ULBD group (n = 61). Clinical outcomes, perioperative indicators, postoperative recovery metrics, foraminal area, cross-sectional area of the dural sac, complication rates, surgical satisfaction, and factors interfering with surgical efficacy were retrospectively analyzed.
No significant difference in the overall effectiveness rate between the two groups (P > 0.05). The bichannel group had shorter incision length, less blood loss, and a shorter surgery time compared to the unichannel group (P < 0.05). At postoperative days 3, 3 months, and 6 months, the VAS scores for back pain and leg pain, as well as the ODI scores in the bichannel group, were significantly lower than those in the unichannel group (P < 0.05), whereas the JOA scores were higher (P < 0.05). One month postoperatively, the cognitive, physical, role, and social function scores in the bichannel group were higher than those in the unichannel group (P < 0.05), and both the foraminal area and cross-sectional area of the dural sac were greater in the bichannel group (P < 0.05). The complication rate in the bichannel group was lower than that in the unichannel group (P < 0.05), and the surgical satisfaction rate was higher in the bichannel group (P < 0.05). Factors interfering with efficacy included age, duration of illness, intramedullary signal edema type, cystic type, preoperative annulus fibrosus rupture, and lumbar instability (P < 0.05).
Bichannel endoscopic ULBD surgery yields superior outcomes compared to unichannel surgery in lumbar spinal stenosis patients. Age, disease duration, and certain preoperative conditions are significant factors influencing efficacy.
比较单侧单通道与双通道内镜下双侧减压腰椎板切开术（ULBD）治疗腰椎管狭窄症患者的疗效，并分析影响疗效的因素。
本回顾性研究纳入了2022年6月至2024年6月期间在亳州市人民医院接受治疗的122例确诊为腰椎管狭窄症的患者。根据手术方式将患者分为两组：单通道内镜ULBD组（n = 61）和双通道内镜ULBD组（n = 61）。回顾性分析临床疗效、围手术期指标、术后恢复指标、椎间孔面积、硬膜囊横截面积、并发症发生率、手术满意度以及影响手术疗效的因素。
两组总体有效率差异无统计学意义（P > 0.05）。与单通道组相比，双通道组切口长度更短、出血量更少、手术时间更短（P < 0.05）。术后3天、3个月和6个月时，双通道组的背痛和腿痛视觉模拟评分（VAS）以及腰椎功能障碍指数（ODI）评分均显著低于单通道组（P < 0.05），而日本骨科协会（JOA）评分更高（P < 0.05）。术后1个月，双通道组的认知、身体、角色和社会功能评分高于单通道组（P < 0.05），且双通道组的椎间孔面积和硬膜囊横截面积更大（P < 0.05）。双通道组的并发症发生率低于单通道组（P < 0.05），手术满意度高于单通道组（P < 0.05）。影响疗效的因素包括年龄、病程、髓内信号水肿类型、囊肿类型、术前纤维环破裂以及腰椎不稳（P < 0.05）。
对于腰椎管狭窄症患者，双通道内镜ULBD手术的疗效优于单通道手术。年龄、病程和某些术前情况是影响疗效的重要因素。
