[1]欧阳永江,范庆斌,李刚,等.侧双通道内镜辅助下与常规后路椎体间融合术治疗腰椎退行性疾病的比较研究[J].中国中医骨伤科杂志,2025,33(11):40-44+50.[doi:10.20085/j.cnki.issn1005-0205.251108]
　OUYANG Yongjiang,FAN Qingbin,LI Gang,et al.Comparison of the Efficacy of Unilateral Biportal Endoscopic-Lumbar Guided by Tianji Robot and Conventional Posterior Lumbar Interbody Fusion in Treating Patients with Single-Level Degenerative Lumbar Disease:A Retrospective Study[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(11):40-44+50.[doi:10.20085/j.cnki.issn1005-0205.251108]
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侧双通道内镜辅助下与常规后路椎体间融合术治疗腰椎退行性疾病的比较研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年11期
页码:
40-44+50
栏目:
临床研究
出版日期:
2025-11-15

文章信息/Info

Title:
Comparison of the Efficacy of Unilateral Biportal Endoscopic-Lumbar Guided by Tianji Robot and Conventional Posterior Lumbar Interbody Fusion in Treating Patients with Single-Level Degenerative Lumbar Disease:A Retrospective Study
文章编号:
1005-0205(2025)11-0040-05
作者:
欧阳永江1; 范庆斌1; 李刚1; 马蔚蔚1; 方枫1; 李定文1; 梁铁军1; 戴贺1△
1荆门市中医医院(湖北 荆门,448000)
Author(s):
OUYANG Yongjiang1; FAN Qingbin1; LI Gang1; MA Weiwei1; FANG Feng1; LI Dingwen1; LIANG Tiejun1; DAI He1△
1Jingmen Traditional Chinese Medicine Hospital,Jingmen 448000,Hubei China.
关键词:
腰椎退行性疾病;  单侧双通道脊柱内镜腰椎椎体间融合术;  常规后路腰椎椎体间融合术;  疗效
Keywords:
degenerative lumbar disease;  unilateral biportal endoscopic lumbar interbody fusion;  conventional posterior lumbar interbody fusion;  efficacy
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.251108
文献标志码:
A
摘要:
目的:比较单侧双通道内镜辅助下腰椎单节段椎体间融合手术(UBE-LIF)与常规后路腰椎椎体间融合术(PLIF)治疗腰椎退行性疾病的临床疗效与安全性。方法:纳入2023年1月至2024年6月收治的64例腰椎退行性疾病患者为研究对象,采用随机数字表法将患者随机分为两组,每组各32例。其中机器人单侧双通道内镜技术组接受单侧双通道内镜辅助下腰椎单节段椎体间融合手术治疗,后路腰椎椎体间融合术组患者接受常规后路腰椎椎体间融合术治疗,并对两组患者手术前后视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、日本骨科学会(JOA)评分、红细胞沉降率(ESR)、白细胞介素-6(IL-6)浓度、术后融合率等关键指标加以统计。结果:机器人单侧双通道内镜技术组手术平均用时(180.09±20.08)min,比后路腰椎椎体间融合术组(136.22±18.34)min要长; 不过机器人单侧双通道内镜技术组术中平均出血量(107.03±23.41)mL,术后3 d累计引流量平均(173.03±16.48)mL,均比后路腰椎椎体间融合术组的平均出血量(140.16±43.13)mL及术后3 d累计引流量(214.53±12.40)mL低,且差异有统计学意义(P<0.05)。术后机器人单侧双通道内镜技术组VAS评分和ODI评分均低于后路腰椎椎体间融合术组,差异有统计学意义(P<0.05); 而机器人单侧双通道内镜技术组JOA评分则高于后路腰椎椎体间融合术组,差异有统计学意义(P<0.05); 机器人单侧双通道内镜技术组术后IL-6浓度和红细胞沉降率也低于后路腰椎椎体间融合术组,差异有统计学意义(P<0.05); 术后12个月两组患者融合率差异无统计学意义(P>0.05)。结论:在治疗腰椎退行性疾病方面,单侧双通道内镜辅助下腰椎单节段椎体间融合手术时间比常规后路腰椎椎体间融合术长,但术后恢复期各项指标改善明显,术后痛感减轻,功能障碍级别降低且对内在环境影响小,引起的炎症反应较轻。这两种手术方式安全性和效率都有保证且能达到满意疗效,长期融合效果相当。对于单一节段腰椎退变性病症,单侧双通道内镜辅助下腰椎单节段椎体间融合手术比常规后路腰椎椎体间融合术创伤小,术后腰椎功能恢复好且疼痛缓解佳,炎症反应也更轻微。
Abstract:
Objective:To comparatively analyze the clinical outcomes of unilateral biportal endoscopic-assisted lumbar single-segment interbody fusion(UBE-LIF)surgery and conventional posterior lumbar interbody fusion(PLIF)surgery in patients with lumbar degenerative diseases,thereby providing a basis for clinical treatment decisions.Methods:This study is a randomized controlled trial(RCT).A total of 64 patients with lumbar degenerative diseases from January 2023 to June 2024 were enrolled as the study subjects.The patients were randomly assigned to two groups using random number table method,with 32 patients in each group.The robot-assisted unilateral biportal endoscopic(UBE)group(robot-UBE group)received UBE-LIF surgery,while the posterior lumbar interbody fusion(PLIF)group(PLIF group)received conventional PLIF surgery.Key indicators such as preoperative and postoperative visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,Japanese orthopaedic association(JOA)scores,erythrocyte sedimentation rate(ESR),interleukin-6(IL-6)concentration,and postoperative fusion rate were analyzed across the two patient cohorts.Results:The mean operative time in the robot-UBE group was(180.09±20.08)min,which was longer than that in the PLIF group(136.22±18.34)min.However,the mean intraoperative blood loss in the robot-UBE group were(107.03±23.41)mL,the mean postoperative drainage volume were(173.03±16.48)mL.All these values were lower than those in the PLIF group,with mean intraoperative blood loss of(140.16±43.13)mL,mean postoperative drainage volume of(214.53±12.40)mL.Moreover,all the compared differences were statistically significant(P<0.05).Postoperatively,the VAS scores and ODI scores in the robot-UBE group were lower than those in the PLIF group(P<0.05),while the JOA scores in the robot-UBE group was higher than that in the PLIF group(P<0.05).The postoperative IL-6 concentration and ESR in the robot-UBE group were also lower than those in the PLIF group(P<0.05).There was no significant difference in the fusion rate between the two groups at 12 months after surgery(P>0.05).Conclusion:In the treatment of lumbar degenerative diseases,although the operative time of UBE-LIF is longer than that of PLIF,UBE-LIF shows significant improvements in various postoperative recovery indicators,alleviates postoperative pain,reduces the level of functional disability,has a minor impact on the internal environment,and elicits a milder inflammatory response.Both surgical approaches(UBE-LIF and PLIF)ensure safety and efficiency and can achieve satisfactory therapeutic effects,with comparable long-term fusion outcomes.For single-segment degenerative lumbar diseases,UBE-LIF has less trauma,better postoperative lumbar function recovery,more effective pain relief,and a milder inflammatory response compared to PLIF.

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(收稿日期:2025-07-07)

备注/Memo

备注/Memo:
基金项目:湖北省卫生健康委科研项目(WJ2023F081)
△通信作者 E-mail:24657203@qq.com
更新日期/Last Update: 2025-11-15