单侧双通道脊柱内镜下Sublamina入路治疗腰椎间盘突出症合并椎管狭窄的短期疗效

Short-term curative effect evaluation of unilateral biportal endoscopy through Sublamina approach for lumbar intervertebral foramen stenosis combined with lumbar disc herniation

摘要:

目的 评价单侧双通道脊柱内镜（UBE）下Sublamina入路腰椎椎管减压手术，治疗椎间孔区域腰椎间盘突出症合并椎管狭窄的短期疗效。方法 回顾性分析2021年10月－2022年6月该院收治的7例有典型根性症状，突出位于椎间孔区域，造成双根受压同时伴有椎管狭窄的老年患者的临床资料。其中，L_4/5间隙6例，L₅/S₁间隙1例，平均病程（8.6±2.5）个月。所有患者均通过UBE下Sublamina入路进行治疗。结果 7例患者术后下肢症状明显缓解，视觉模拟评分法（VAS）术前（8.6±1.3）分，术后2 d（2.1±1.1）分，日本骨科协会（JOA）评分术前（10.1±2.4）分，术后2 d（17.3±1.8）分，手术前后比较，差异均有统计学意义（P < 0.05）。结论 UBE下Sublamina入路椎管减压手术治疗椎间孔区域腰椎间盘突出症合并椎管狭窄，临床效果满意，值得推广应用。

Abstract:

Objective To explore the efficacy of unilateral biportal endoscopy (UBE) for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach.Methods From October 2021 to June 2022, 7 elderly patients with typical symptoms of lumbar disc herniation in the intervertebral foramen area accompanied by spinal stenosis were retrospectively analyzed. There were 6 patients with lumbar disc herniation and nerve root canal stenosis at L_4/5 and 1 patient at L₅/S₁. The mean course of disease was (8.6 ± 2.5) months. All the patients were treated by UBE through Sublamina approach.Results Postoperative limb radicular symptoms of 7 patients were relieved. The visual analogue scale (VAS) of limb pain was significantly decreased from preoperative (8.6 ± 1.3) to (2.1 ± 1.1) at 2 d after the surgery (P < 0.05), the Japanese Orthopaedic Association (JOA) score was significantly increased from preoperative (10.1 ± 2.4) to (17.3 ± 1.8) at 2 d after the surgery (P < 0.05).Conclusion UBE for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach has a satisfactory therapeutic effect, providing a new idea for the surgical treatment of this disease.