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腰椎间盘突出症患者行单侧双孔通道内镜下腰椎间盘切除术时纤维环缝合与否的比较结果:一项回顾性分析

Comparative outcomes of unilateral biportal endoscopic lumbar intervertebral discectomy with and without annulus fibrosus suture in lumbar disc herniation: a retrospective analysis.

作者信息

Zhou Wei, Bangura Mohamed Lamin, Gong Qianlong, Zhang Rong, Zeng Teng, Fei Qi, Chirima Tadiwa Chiedza, Tran Sy-Trung, Qiu Yutian, Luo Huasong

机构信息

Department of Orthopedics, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China.

Yangtze University Health Centre, Jingzhou, Hubei, China.

出版信息

Front Surg. 2025 Apr 29;12:1521892. doi: 10.3389/fsurg.2025.1521892. eCollection 2025.


DOI:10.3389/fsurg.2025.1521892
PMID:40364917
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12069353/
Abstract

BACKGROUND: Advancements in minimally invasive spine surgery have markedly enhanced patient outcomes in the management of lumbar intervertebral disc herniation and degenerative disorders. The Unilateral Biportal Endoscopic Interlaminar Lumbar Intervertebral Discectomy and spinal nerve decompression are prominent of these methods. This method is based on the principles established by several endoscopic spine techniques, which are lauded for their limited invasiveness, less trauma, and expedited recovery periods in contrast to conventional open operations. METHODS: 177 patients treated with Unilateral Biportal Endoscopic Transforaminal Lumbar Intervertebral Discectomy for lumbar disc herniation were selected and assigned into Sutured (39 patients) and Un-sutured groups (138 patients). Different variables, including clinical outcomes and estimated cost, were evaluated using IBM SPSS 27.0.1 with a -value < 0.05 considered statistically significant. RESULTS: The study identified disparities in clinical outcomes, such as reoperation problems, surgery durations, and projected costs between the two groups. Reoperation rates were lower in the sutured group. Un-sutured patients had a shorter surgery time. Both groups had comparable Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) scores. Both groups have similar Body Mass Indexes (BMIs) throughout hospitalization. The two groups had equal discharge satisfaction scores. There is not much variation in surgical bleeding across groups. Follow-up times were identical for both groups (26.46 ± 2.01 for the sutured group and 26.83 ± 2.68 for the un-sutured group). The two groups showed a slight difference in estimated costs, with the sutured group averaging RMB 29,234.78 ± 5,265.83, compared to RMB 22,311.10 ± 3,527.00 for the un-sutured group. CONCLUSION: Annulus fibrosus suturing during minimally invasive lumbar disc surgery may increase time and expense and reduce the risk of recurrent herniation and reoperation. Sutured and non-sutured techniques have equal clinical results and low intraoperative blood loss, making them feasible alternatives depending on the situation and patient demands.

摘要

背景:微创脊柱手术的进展显著改善了腰椎间盘突出症和退行性疾病的治疗效果。单侧双孔道内镜下腰椎间盘切除术和脊神经减压术是这些方法中的突出代表。该方法基于多种内镜脊柱技术所确立的原则,与传统开放手术相比,因其侵入性有限、创伤较小且恢复周期较快而备受赞誉。 方法:选取177例行单侧双孔道内镜下经椎间孔腰椎间盘切除术治疗腰椎间盘突出症的患者,分为缝合组(39例)和未缝合组(138例)。使用IBM SPSS 27.0.1评估包括临床结果和估计费用在内的不同变量,P值<0.05被认为具有统计学意义。 结果:该研究发现两组在临床结果方面存在差异,如再次手术问题、手术时长和预计费用。缝合组的再次手术率较低。未缝合患者的手术时间较短。两组的视觉模拟评分(VAS)和日本骨科协会(JOA)评分相当。两组在整个住院期间的体重指数(BMI)相似。两组的出院满意度评分相同。各组之间的手术出血量差异不大。两组的随访时间相同(缝合组为26.46±2.01,未缝合组为26.83±2.68)。两组在估计费用上存在细微差异,缝合组平均为29234.78元±5265.83元,未缝合组为22311.10元±3527.00元。 结论:微创腰椎间盘手术中纤维环缝合可能会增加时间和费用,并降低复发疝和再次手术的风险。缝合和未缝合技术具有相同的临床效果且术中失血少,根据具体情况和患者需求,它们都是可行选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/56ae1574d183/fsurg-12-1521892-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/e402f19233ad/fsurg-12-1521892-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/25ce77f6ac1c/fsurg-12-1521892-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/56ae1574d183/fsurg-12-1521892-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/e402f19233ad/fsurg-12-1521892-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/25ce77f6ac1c/fsurg-12-1521892-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74cf/12069353/56ae1574d183/fsurg-12-1521892-g003.jpg

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Comparative outcomes of unilateral biportal endoscopic lumbar intervertebral discectomy with and without annulus fibrosus suture in lumbar disc herniation: a retrospective analysis.

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本文引用的文献

[1]
Stem cell therapy for degenerative disc disease: Bridging the gap between preclinical promise and clinical potential.

Biomol Biomed. 2024-3-11

[2]
Comparison of the Interlaminar and Transforaminal Approaches for Full-endoscopic Discectomy for the Treatment of L4/5 Lumbar Disc Herniation.

Neurol Med Chir (Tokyo). 2023-7-15

[3]
Percutaneous Endoscopic Lumbar Discectomy via Transforaminal Approach Combined with Interlaminar Approach for L4/5 and L5/S1 Two-Level Disc Herniation.

Orthop Surg. 2021-5

[4]
The Effect of Degeneration on Internal Strains and the Mechanism of Failure in Human Intervertebral Discs Analyzed Using Digital Volume Correlation (DVC) and Ultra-High Field MRI.

Front Bioeng Biotechnol. 2021-1-21

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World Neurosurg. 2021-2

[6]
Technical Considerations of the Transforaminal Approach for Lumbar Disk Herniation.

World Neurosurg. 2021-1

[7]
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World Neurosurg. 2020-7

[8]
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Int J Surg. 2020-3-9

[9]
Removal of calcified lumbar disc herniation with endoscopic-matched ultrasonic osteotome - Our preliminary experience.

Br J Neurosurg. 2020-2

[10]
Implementation of Transforaminal Endoscopic Lumbar Sequestrectomy in a German University Hospital Setting: A Long and Rocky Road.

J Neurol Surg A Cent Eur Neurosurg. 2020-1

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