[1]朱小龙,华永均△,王勇,等.单边双通道脊柱内镜技术治疗脱出游离型腰椎间盘突出症[J].中国中医骨伤科杂志,2025,33(02):86-90.[doi:10.20085/j.cnki.issn1005-0205.250217]
　ZHU Xiaolong,HUA Yongjun,WANG Yong,et al.Clinical Effect of Unilateral Biportal Endoscopy in the Treatment of Prolapse Type Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(02):86-90.[doi:10.20085/j.cnki.issn1005-0205.250217]
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单边双通道脊柱内镜技术治疗脱出游离型腰椎间盘突出症()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年02期
页码:
86-90
栏目:
临床报道
出版日期:
2025-02-15

文章信息/Info

Title:
Clinical Effect of Unilateral Biportal Endoscopy in the Treatment of Prolapse Type Lumbar Disc Herniation
文章编号:
1005-0205(2025)02-0086-05
作者:
朱小龙1; 华永均1△; 王勇1; 郭志辉1; 陈威烨1; 陶其杰1
1杭州市富阳中医骨伤医院(杭州,311400)
Author(s):
ZHU Xiaolong1; HUA Yongjun1△; WANG Yong1; GUO Zhihui1; CHEN Weiye1; TAO Qijie1
1Hangzhou Fuyang Traditional Chinese Medicine Orthopedic Hospital,Hangzhou 311400,China.
关键词:
单边双通道内镜;  微创手术;  腰椎间盘突出症;  脱出型椎间盘突出;  游离型椎间盘突出
Keywords:
unilateral biportal endoscopy;  minimally invasive surgery;  lumbar disc herniation;  prolapsed disc herniation;  free disc herniation
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.250217
文献标志码:
B
摘要:
目的:探讨单边双通道脊柱内镜技术(UBE)治疗脱出游离型腰椎间盘突出症的疗效及安全性。方法:对2022年1月至2024年1月接受单边双通道脊柱内镜技术治疗的40例脱出游离型腰椎间盘突出患者临床资料进行回顾性分析。男23例,女17例; 平均年龄为(54.55±13.35)岁; 患病节段为L2/3节段1例,L3/4节段3例,L4/5节段28例,L5S1节段8例。32例向下脱出游离,8例向上脱出游离。记录术前、术后第1天、1个月及末次随访时腰腿痛视觉模拟量表(VAS)评分、腰椎Oswestry功能障碍指数(ODI)评分、末次随访时手术优良率及并发症发生情况。结果:40例患者均顺利完成手术,平均手术时间为(80.83±17.25)min,透视次数为(4.08±1.34)次,切口均甲级愈合,患者均获得随访,随访时间为(14.78±5.89)个月。患者术前腰痛VAS评分为(5.03±0.80)分、术后第1天为(2.45±0.67)分、术后1个月为(1.95±0.74)分、末次随访时为(1.35±0.48)分,术前腿痛VAS评分为(7.20±0.82)分、术后第1天为(2.38±0.54)分、术后1个月为(2.05±0.67)分、末次随访时为(1.55±0.59)分; 术前腰痛ODI评分为63.85%±6.28%,术后第1天为14.45%±4.84%,术后1个月为10.95%±3.26%,末次随访时为8.85%±2.86%; 本组患者末次随访时手术疗效,优37例,良2例,可1例,差0例,优良率为97.5%,发生硬膜外血肿1例,经过保守治疗后好转,其余无感染、髓核残留、腰椎不稳、神经根损伤及硬膜撕裂等并发症。结论:单边双通道脊柱内镜技术治疗脱出游离型椎间盘突出安全有效,且透视次数少,辐射小,椎管内探查范围广,减压相对比较彻底,症状不易残留和复发。
Abstract:
Objective:To explore the efficacy and safety of unilateral biportal endoscopic(UBE)technology in the treatment of free-floating lumbar disc herniation.Methods:A retrospective analysis was conducted on the clinical data of 40 patients with free-floating lumbar disc herniation treated with UBE spinal endoscopy technology from January 2022 to January 2024.There were 23 males and 17 females,with an average age of(54.55±13.35)years old.The affected segments were L2/3 in 1 case,L3/4 in 3 cases,L4/5 in 28 cases,and L5S1 in 8 cases.32 cases had downward free-floating,and 8 cases had upward free-floating.The visual analogue scale(VAS)scores for low back and leg pain,Oswestry disability index(ODI)scores,the rate of good and excellent surgical outcomes at the last follow-up,and the occurrence of complications were recorded.Results:All 40 patients successfully underwent surgery,with an average operation time of(80.83±17.25)min,an average of(4.08±1.34)fluoroscopies.All incisions healed with first-degree union,and all patients were followed up,with a follow-up time of(14.78±5.89)months.The preoperative VAS score for low back pain was(5.03±0.80)points,on the first postoperative day(2.45±0.67)points,at one month postoperatively(1.95±0.74)points,and at the last follow-up(1.35±0.48)points.The VAS score for leg pain was(7.20±0.82)points,on the first postoperative day(2.38±0.54)points,at one month postoperatively(2.05±0.67)points,and at the last follow-up(1.55±0.59)points.The ODI score for low back pain was 63.85%±6.28%,on the first postoperative day 14.45%±4.84%,at one month postoperatively 10.95%±3.26%,and at the last follow-up 8.85%±2.86%.At the last follow-up,the surgical outcomes were excellent in 37 cases,good in 2 cases,fair in 1 case,and poor in 0 case,with a good and excellent rate of 97.5%.One case of epidural hematoma occurred,which improved after conservative treatment,and no other complications such as infection,residual nucleus pulposus,lumbar instability,nerve root injury,or dural tear occurred.Conclusion:UBE spinal endoscopy technology is safe and effective in the treatment of free-floating lumbar disc herniation,with fewer fluoroscopies,less radiation,a wider range of exploration in the spinal canal,relatively thorough decompression,and less likelihood of residual and recurrence.

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备注/Memo

备注/Memo:
基金项目:杭州市医药卫生科技项目(B20220070)
△通信作者 E-mail:zxlspine@yeah.net
更新日期/Last Update: 2025-02-15