单侧双通道脊柱内镜减压术治疗腰椎间盘突出症的临床疗效

Clinical efficacy of unilateral biportal endoscopic decompression for lumbar disc herniation

摘要:

目的 观察单侧双通道脊柱内镜（UBE）减压术治疗腰椎间盘突出症的临床有效性。方法 收集2021年1月－2022年3月于该院骨科就诊并行UBE减压术治疗的腰椎间盘突出症患者80例，分别在术前、术后1 d、术后3、6和12个月，采用视觉模拟评分法（VAS）评估患者疼痛情况，采用Oswestry功能障碍指数（ODI）评估肢体功能，采用日本骨科协会（JOA）评分评价患者腰椎功能。结果 术前患者腰背部VAS为（5.72±2.18）分，术后1 d、术后3、6和12个月分别下降至（2.74±1.52）、（1.92±1.26）、（1.73±1.36）和（0.87±0.72）分，与术前比较，差异均有统计学意义（P < 0.05）。患者腿部VAS术前为（4.63±2.17）分，术后1 d下降至（4.22±1.91）分，术前术后比较，差异无统计学意义（P > 0.05）；术后3个月VAS为（3.73±1.42）分，术后6个月为（2.13±1.16）分，术后12个月为（0.76±0.63）分，与术前比较，差异有统计学意义（P < 0.05）；术前ODI为（60.23±8.13）%，术后1 d、术后3、6和12个月分别下降至（41.91±6.53）%、（12.82±4.24）%、（8.19±3.84）%和（6.75±2.14）%，与术前比较，差异均有统计学意义（P < 0.05）。术前JOA评分为（9.08±1.34）分，术后1 d为（10.89±0.88）分，术后3个月为（13.34±1.25）分，术后6个月为（15.75±1.24）分，术后12个月为（18.12±1.86）分，与术前比较，腰椎功能明显改善（P < 0.05）。结论 UBE减压术治疗腰椎间盘突出症，疗效满意，其为腰椎间盘突出症的治疗提供了另一种选择，值得临床推广应用。

Abstract:

Objective To observe the clinical effectiveness of unilateral biportal endoscopy (UBE) decompression in the treatment of lumbar disc herniation.Methods 80 patients with lumbar disc herniation who were treated with UBE decompression from January 2021 to March 2022 were collected, and the visual analogue scale (VAS) was applied to assess patient pain, Oswestry disability index (ODI) to assess limb function, and the Japanese Orthopaedic Association (JOA) score to evaluate patient vertebral body function at the preoperative and postoperative periods of 1 day, 3 months, 6 months, and 12 months, respectively.Results The mean VAS of the lumbar and back of patients before surgery was (5.72 ± 2.18), (2.74 ± 1.52), （1.92 ± 1.26), (1.73 ± 1.36), and (0.87 ± 0.72) at the 1 day, 3 months, 6 months, and 12 months after surgery, respectively, with statistical significance (P < 0.05). The VAS of the patient’s leg decreased from (4.63 ± 2.17) to (4.22 ± 1.91) before and 1 day after surgery, with no significant difference (P > 0.05), at 3 months (3.73 ± 1.42), 6 months (2.13 ± 1.16), and 12 months (0.76 ± 0.63) after surgery, with statistical significances (P < 0.05); The preoperative ODI of the patients was (60.23 ± 8.13)%, and decreased to (41.91 ± 6.53)%, (12.82 ± 4.24)%, (8.19 ± 3.84)%, and (6.75 ± 2.14)% after 1 day, 3 months, 6 months, and 12 months of follow-up, respectively, with statistical significances (P < 0.05). The preoperative JOA scores was (9.08 ± 1.34), 1 day after surgery, the score was (10.89 ± 0.88), 3 months (13.34 ± 1.25), 6 months (15.75 ± 1.24), and 12 months (18.12 ± 1.86) after surgery, with significant improvement in lumbar function (P < 0.05).Conclusion UBE decompression can achieve good clinical efficacy in the treatment of lumbar disc herniation, providing another option for the treatment of lumbar disc herniation, which is worth promoting.