Xu Wanlong, Si Haipeng, Zhao Yulin
Department of Orthopedics, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, People's Republic of China.
Department of Orthopedics, Qilu Hospital of Shandong University (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, 266035, Shandong, People's Republic of China.
Sci Rep. 2025 Jul 1;15(1):21715. doi: 10.1038/s41598-025-08214-9.
This study aims to compare the efficacy of two endoscopic instruments powered osteotome and powered drill in treating single-segment degenerative lumbar spinal stenosis via unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF). We retrospectively analyzed clinical data from 127 patients treated at Qilu Hospital of Shandong University between January 2021 and December 2022. Patients were divided into two groups: the bone-drill (BD) group (71 cases) and the bone-osteotome (BO) group (56 cases). Various surgical indicators were assessed, including operation time, intraoperative blood loss, postoperative drainage volume, length of hospital stay, and complication rates. Clinical efficacy was evaluated using the visual analog scale (VAS) for lower back and limb pain, the Oswestry Disability Index (ODI), modified MacNab criteria, and the Brantigan and Steffee method for interbody fusion assessment. Results showed that the BD group had an average operation time of 151.41 ± 19.03 min, whereas the BO group completed the procedure significantly faster, averaging 128.48 ± 16.92 min. Intraoperative blood loss was comparable between groups (BD: 102.11 ± 34.26 ml; BO: 120.70 ± 32.89 ml). The BO group showed higher postoperative drainage volume (85.47 ± 19.01 ml) than the BD group (71.25 ± 14.55 ml). Hospitalization durations were similar (BD: 8.92 ± 1.22 days; BO: 9.16 ± 1.12 days). Both groups showed significant improvement in VAS and ODI scores at 3 and 12 months post-surgery (P < 0.05), with no significant differences between groups (P > 0.05). Notably, the BO group exhibited superior intervertebral fusion quality at 3 months compared to the BD group (P < 0.05), with no differences observed at 12 months. In conclusion, the UBE-TLIF technique employing a powered osteotome significantly reduces operation time and enhances intervertebral fusion compared to the powered drill method.
本研究旨在比较两种内镜动力骨凿和动力钻在通过单侧双孔道内镜下经椎间孔腰椎椎间融合术（UBE-TLIF）治疗单节段退变性腰椎管狭窄症中的疗效。我们回顾性分析了2021年1月至2022年12月在山东大学齐鲁医院接受治疗的127例患者的临床资料。患者分为两组：骨钻（BD）组（71例）和骨凿（BO）组（56例）。评估了各种手术指标，包括手术时间、术中出血量、术后引流量、住院时间和并发症发生率。使用视觉模拟量表（VAS）评估下背部和肢体疼痛、Oswestry功能障碍指数（ODI）、改良MacNab标准以及Brantigan和Steffee椎间融合评估方法来评价临床疗效。结果显示，BD组平均手术时间为151.41±19.03分钟，而BO组完成手术的速度明显更快，平均为128.48±16.92分钟。两组术中出血量相当（BD组：102.11±34.26毫升；BO组：120.70±32.89毫升）。BO组术后引流量（85.47±19.01毫升）高于BD组（71.25±14.55毫升）。住院时间相似（BD组：8.92±1.22天；BO组：9.16±1.12天）。两组在术后3个月和12个月时VAS和ODI评分均有显著改善（P<0.05），组间无显著差异（P>0.05）。值得注意的是，与BD组相比，BO组在术后3个月时椎间融合质量更好（P<0.05），在12个月时未观察到差异。总之，与动力钻方法相比，采用动力骨凿的UBE-TLIF技术显著缩短了手术时间并提高了椎间融合效果。
