Abstract:

Objective　To investigate the short-term clinical efficacy of unilateral biportal endoscopic (UBE) nerve root release surgery in the treatment of lumbar spinal stenosis. Methods　A total of 18 patients with lumbar spinal stenosis who were admitted to the First Affiliated Hospital of Wannan Medical College from May to November 2023 were included. Among them, there were 9 males and 9 females, with ages ranging from 36 to 76 (52.78±8.98) years old, and the affected segments were L3/4 in 1 case, L4/5 in 9 cases, and L5/S1 in 8 cases. All the patients underwent UBE nerve root release surgery. The Visual Analogue Scale (VAS) scores of low back pain and leg pain and Oswestry Disability Index (ODI) before surgery, on the first day after surgery, and at the last follow-up were compared; the clinical efficacy at the last follow-up was evaluated using the MacNab scoring system. Statistical analysis was conducted using analysis of variance and Dunnett's T3 multiple comparison method. Results　All 18 patients successfully completed the surgery without any complication during or after surgery. The surgical duration ranged from 35 to 130 (75.17±24.21) minutes, the postoperative hospital stay was 1 to 8 (2.22±1.59) days, and the follow-up period was 13 to 18 (16.00±1.81) months. On the first day after surgery, there was no statistically significant difference in the VAS score of lower back pain compared to the preoperative score (P>0.05); the VAS score of lower back pain at the last follow-up was lower than that before surgery and on the first day after surgery, with statistically significant differences (both P<0.05). The VAS scores of leg pain and ODIs on the first day after surgery and at the last follow-up were all improved compared to those before surgery (all P<0.05). At the last follow-up, the clinical efficacy was evaluated using the MacNab score: excellent in 15 cases, good in 1 case, and fair in 2 cases, with an excellent and good rate of 88.89% (16/18). Conclusion　UBE nerve root release surgery for lumbar spinal stenosis can achieve satisfactory clinical efficacy, providing another minimally invasive surgical option for lumbar spinal stenosis, and is conducive to the patients' rapid rehabilitation.

Key words:

Lumbar spinal stenosis, Unilateral biportal endoscopy, Nerve root release surgery, Clinical efficacy

摘要：

目的　探讨单侧双通道内镜（unilateral biportal endoscopy，UBE）神经根松解术治疗腰椎管狭窄症的短期临床疗效。方法　共纳入2023年5月至11月皖南医学院第一附属医院收治的腰椎管狭窄症患者18例，其中男9例，女9例，年龄36～76（52.78±8.98）岁，责任节段：L3/4 1例、L4/5 9例、L5/S1 8例。患者均接受UBE神经根松解术治疗。比较术前、术后第1天以及末次随访腰痛视觉模拟评分法（Visual Analogue Scale，VAS）评分、腿痛VAS评分、Oswestry功能障碍指数（Oswestry Disability Index，ODI）；采用MacNab评分评价末次随访临床疗效。采用方差分析、Dunnett’s T3多重比较进行统计学分析。结果　18例患者均顺利完成手术，术中及术后均未出现并发症。手术时间为35～130（75.17±24.21）min，术后住院时间为1～8（2.22±1.59）d，随访时间13～18（16.00±1.81）个月。患者术后第1天腰痛VAS评分和术前比较差异无统计学意义（P>0.05），末次随访腰痛VAS评分低于术前及术后第1天，差异均有统计学意义（均P<0.05）；术后第1天及末次随访腿痛VAS评分及ODI均较术前改善（均P<0.05）。末次随访时采用MacNab评分评价疗效：优15例、良1例、可2例，优良率为88.89%（16/18）。结论　UBE神经根松解术治疗腰椎管狭窄症可以获得满意的临床疗效，为腰椎管狭窄症提供了另一种微创手术方式，且有利于患者的快速康复。

关键词:

腰椎管狭窄症, 单侧双通道内镜, 神经根松解术, 临床疗效