远外侧经椎间孔单通道双侧入路内镜下腰椎间盘切除术治疗上位腰椎间盘突出症

Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations.

作者信息

Hwang Jin Seop, Lee Sang Hyub, Jeong Dain, Jang Jae-Won, Cho Yong Eun, Lee Dong-Geun, Park Choon Keun, Chough Chung Kee

机构信息

Department of Neurosurgery, Spine Center, The Leon Wiltse Memorial Hospital, Suwon, Korea.

Department of Nursing, Changshin University, Changwon, Korea.

出版信息

Neurospine. 2025 Mar;22(1):14-27. doi: 10.14245/ns.2550058.029. Epub 2025 Mar 31.

OBJECTIVE

The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region.

METHODS

We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed.

RESULTS

A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1-2 level in 3 patients (11.1%), L2-3 in 9 patients (33.3%), and L3-4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001).

CONCLUSION

The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.

目的

上腰椎区域具有独特的解剖学特征，这给椎间盘切除术带来了挑战。我们介绍了用于上腰椎区域中央或旁中央型椎间盘突出症的远外侧经椎间孔单侧双通道内镜（UBE）腰椎间盘切除术。

方法

我们对2018年1月至2024年9月在我院接受远外侧经椎间孔UBE腰椎间盘切除术的患者进行了回顾性研究。回顾了患者的电子病历、手术记录和影像学图像。

结果

共有27例患者接受了远外侧经椎间孔UBE腰椎间盘切除术治疗上腰椎区域的中央或旁中央型椎间盘突出症。患者的平均年龄为54.0±13.7岁。3例患者（11.1%）在L1-2节段进行手术，9例患者（33.3%）在L2-3节段，15例患者（55.6%）在L3-4节段。患者平均随访27.7±19.3个月。Oswestry功能障碍指数从术前的36.3±6.8显著降至末次随访时的3.7±3.3（p<0.001）。视觉模拟评分法（VAS）背痛评分从术前的7.8±0.9显著降至术后第2天的3.1±0.6（p<0.001）。VAS腿痛评分从术前的8.1±0.8显著降至术后第2天的2.3±0.7（p<0.001）。