Wang Qian-Liang, Chen Jian-Peng, Peng Yu-Jian, Dai Jun, Liu Xiao-Feng, Yan Jun
Department of Orthopedic Surgery, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Gusu District, Suzhou, Jiangsu, 215004, China.
BMC Musculoskelet Disord. 2025 Apr 21;26(1):394. doi: 10.1186/s12891-025-08645-5.
In recent years, unilateral biportal endoscopic (UBE) surgery has become one of the most popular minimally invasive spine surgeries. Unlike traditional open surgery, UBE surgery is performed in isotonic saline solution. Therefore, comprehending the water dynamics involved in UBE surgery is crucial.
This prospective study involved 29 patients with single-level lumbar instability or degenerative disk disease who underwent UBE surgery between April 2021 and March 2022. Water flow pressure was measured using a disposable pressure transducer. Multifidus muscle MRI images were analyzed by ImageJ software at intervertebral disc levels. Perioperative blood loss was estimated by the Gross formula. The obtained data were then analyzed with independent t tests, chi-squared tests, and Pearson's correlation.
Height and weight were risk factors for increased water flow pressure during UBE surgery (r = 0.424, P = 0.022, r = 0.384, P = 0.040). The phenomenon of low water flow pressure led to escalations in perioperative total blood loss, hematocrit loss and hemoglobin loss (r = -0.369, P = 0.049, r = -0.424, P = 0.022, r = -0.405, P = 0.029). An excessive water flow pressure can worsen postoperative multifidus swelling and elevate the patient's leg pain visual analogue scale (VAS) score at 1 week (r = 0.442, P = 0.016, r = 0.394, P = 0.034).
Trial registration Chinese Clinical Trial Registry, registration number ChiCTR2300078497, date of registration: 11/12/2023.
Both low and high water flow pressures can have deleterious effects. The water flow pressure should be controlled within a reasonable range during UBE surgery.
近年来，单侧双通道内镜（UBE）手术已成为最受欢迎的微创脊柱手术之一。与传统开放手术不同，UBE手术是在等渗盐溶液中进行的。因此，了解UBE手术中涉及的水动力学至关重要。
这项前瞻性研究纳入了29例患有单节段腰椎不稳或退行性椎间盘疾病的患者，他们于2021年4月至2022年3月期间接受了UBE手术。使用一次性压力传感器测量水流压力。通过ImageJ软件在椎间盘水平分析多裂肌MRI图像。围手术期失血量采用Gross公式估算。然后使用独立t检验、卡方检验和Pearson相关性分析获得的数据。
身高和体重是UBE手术期间水流压力增加的危险因素（r = 0.424，P = 0.022，r = 0.384，P = 0.040）。低水流压力现象导致围手术期总失血量、血细胞比容损失和血红蛋白损失增加（r = -0.369，P = 0.049，r = -0.424，P = 0.022，r = -0.405，P = 0.029）。过高的水流压力会使术后多裂肌肿胀加重，并在1周时提高患者的腿痛视觉模拟量表（VAS）评分（r = 0.442，P = 0.016，r = 0.394，P = 0.034）。
试验注册于中国临床试验注册中心，注册号为ChiCTR2300078497，注册日期：2023年12月11日。
低水流压力和高水流压力都会产生有害影响。在UBE手术期间，应将水流压力控制在合理范围内。
