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管管与单侧双门内镜:在单侧膜切除术后的MRI分析,用于腰椎脊柱狭窄的双边减压

Nicolas Ross^1,2, Carlos Aleman^2,3, Alexandre Dhenin¹

¹Orthosud Montpellier, Clinique Saint Jean Sud de France, Montpellier, France.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|May 31, 2025

概括

与管状解压相比,单侧双门内镜 (UBE) 为腰椎狭窄提供了优越的放射性解压. 然而,这两种最小侵入性技术在手术后一年显示出相似的临床结果和患者满意度.

科学领域:

神经外科神经外科
整形外科手术整形外科手术
最少侵入性的脊柱手术

背景情况:

退行性腰椎脊柱狭窄症通常需要手术干预,当保守的管理失败时.
最少侵入性的手术技术,如单侧拉美切除术用于双侧减压,由于减少了组织创伤和有效减压,越来越多地优先于传统的开放式拉美切除术.
本研究评估和比较了两种微创方法的放射和临床结果:管状解压和单侧双门内镜 (UBE).

研究的目的:

为了比较管管解压缩与单侧双门内镜 (UBE) 的放射性结果,在患有严重腰椎脊柱狭窄症的患者中.
为了比较管状解压和UBE之间的临床结果,包括手术时间,并发症率,以及患者报告的疼痛和残疾.
评估UBE在早期学习阶段治疗严重腰椎脊柱狭窄症的疗效和安全性.

主要方法:

一项回顾性,单一的,非随机的研究包括103名患有严重的腰椎脊柱狭窄症的患者 (52人接受管状解压,51人接受UBE治疗) 在2020年7月至2024年4月期间.
使用MRI评估了放射性结果,包括前后直径和持续囊表面积变化.
临床结果,如手术时间,并发症率,奥斯威斯特残疾指数 (ODI) 和视觉模拟尺度 (VAS) 疼痛评分,在手术前和手术后3个月和12个月被评估.

主要成果:

与管状解压缩相比,单侧双门内镜 (UBE) 显示前后直径 (4.9 mm 与 3.75 mm 相比) 和持续囊面积 (95.8 mm2 与 85.4 mm2 相比) 的显着增加 (p < 0.001 和 p = 0.038,分别).
这两种技术在3个月和12个月后产生了可比的临床改善,在ODI,VAS得分或患者满意度方面没有显著差异.
虽然这两种方法的整体并发症率都很低,但UBE与较高的症状性血液瘤发病率有关,而不是管状去压缩.

结论:

管管解压和UBE都是腰椎脊柱狭窄的有效手术治疗方法,具有显著的临床益处.
即使在最初的学习阶段,UBE也提供了卓越的放射性减压,这表明它有可能提高疗效.
尽管短期随访 (3个月和1年) 的临床结果相似,但需要进一步的研究来评估长期结果并优化每个技术的患者选择标准.

关键词:

内镜检查是指内镜检查.腰部狭窄症腰部狭窄症脊柱外科手术脊柱外科手术管状收缩机是一个管状收缩机.单侧双门内镜 (UBE) 是一种单侧双门内镜.

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