Zhang Qing-Zhou, Zhang Da-Wei, Wen Hui-Lan, Chen Tao, Chen Jun-Quan, Lu Hai
Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, China.
Department of Operation Room and Anesthesiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, China.
J Orthop Surg Res. 2025 May 30;20(1):547. doi: 10.1186/s13018-025-05932-8.
A novel endoscopic instrument, Lu's retractor, was developed to address the recurrent issue of limited visualisation during unilateral biportal endoscopic (UBE) spinal surgery. Engineered to optimize the surgical field by mitigating soft tissue interference, this device aims to enhance operative precision and efficiency.
This single-center retrospective cohort study analyzed 90 consecutive patients who underwent single-level lumbar discectomy via the UBE technique between June 2023 and June 2024. Based on the type of retractor utilised, patients were categorized into three groups: traditional retractor-assisted UBE discectomy (T-UBE), metal retractor-assisted UBE discectomy (M-UBE), and Lu's retractor-assisted UBE discectomy (Lu-UBE). Perioperative parameters-including operative duration, intraoperative blood loss, and complication incidence-along with clinical outcomes, were systematically recorded and compared to assess the relative efficacy of each retractor.
The Lu-UBE group exhibited significantly reduced hospital stays and intraoperative haemorrhage compared to the T-UBE and M-UBE cohorts. Furthermore, this group reported lower numerical rating scale (NRS) scores for both lumbar and radicular pain, alongside decreased Oswestry Disability Index (ODI) scores. Final follow-up assessments indicated superior Macnab grades, denoting improved functional recovery, and a lower incidence of postoperative complications.
Lu's retractor offers notable advantages over conventional and metal retractors in lumbar UBE discectomy by enhancing intraoperative visualization and minimizing complications. These findings support its potential utility as an effective alternative in minimally invasive spinal procedures.
一种新型的内镜器械——鲁氏牵开器，被研发出来以解决单侧双通道内镜（UBE）脊柱手术中反复出现的视野受限问题。该器械旨在通过减少软组织干扰来优化手术视野，以提高手术精度和效率。
这项单中心回顾性队列研究分析了2023年6月至2024年6月期间连续90例行单节段腰椎间盘切除术的UBE技术患者。根据所使用的牵开器类型，患者被分为三组：传统牵开器辅助UBE椎间盘切除术（T-UBE）、金属牵开器辅助UBE椎间盘切除术（M-UBE）和鲁氏牵开器辅助UBE椎间盘切除术（Lu-UBE）。系统记录围手术期参数，包括手术时间、术中出血量和并发症发生率，以及临床结果，以评估每种牵开器的相对疗效。
与T-UBE组和M-UBE组相比，Lu-UBE组住院时间和术中出血量显著减少。此外，该组腰椎和神经根性疼痛的数字评分量表（NRS）得分较低，同时Oswestry功能障碍指数（ODI）得分也有所下降。最终随访评估显示Macnab分级更高，表明功能恢复更好，术后并发症发生率更低。
在腰椎UBE椎间盘切除术中，鲁氏牵开器在增强术中视野和减少并发症方面比传统牵开器和金属牵开器具有显著优势。这些发现支持了其作为微创脊柱手术有效替代方案的潜在效用。
