| ObjectiveWe collected clinical data of 98 cases of lumbar degenerative diseases treated by unilateral biportal endoscopy and traditional lumbar posterior open surgery from July 2019 to December 2019 in this study,and analyzed the correlation of degenerative lumbar diseases during the perioperative period.Through a follow-up period of at least 12 months,the preoperative and postoperative functional scores were recorded to compare and analyze the curative effect of the two groups of different operations on patients.This study will make us understand the advantages of the emerging technology of unilateral biportal endoscopy and provide a reference for the safety and effectiveness of subsequent operations.MethodsFrom July 2019 to December 2019,98 patients with degenerative diseases of the lumbar spine were collected,including 43 patients with lumbar disc herniation and 55 patients with lumbar spinal stenosis.We applied unilateral biportal endoscopy-assisted lumbar interbody fusion and traditional lumbar posterior open surgery methods,respectively.The patients were divided into two groups according to different surgical methods.Patients in the UBE group underwent UBE-assisted technology treatment.There were 52 patients,28 males and 24 females,aged 22-65 years old,with an average of(45.11 ± 12.30)years old.And a total of 46 patients in the open group received conventional open posterior lumbar surgery,25 males and 21 females,aged 21-63 years old,with an average of(48.84± 9.20)years old.The amount of bleeding during the operation,the time spent in bed after the operation,the operation time,the time of hospitalization,and the complications that occurred during and after the operation were recorded.To evaluate clinical efficacy,we recorded the Japanese Orthopedics Association(JOA)score,Visual Analogue Scale(VAS),and Oswestry Disability Index(ODI)score before surgery,3 days after surgery,3 months after surgery and last followup.Through statistical analysis,the clinical efficacy was evaluated before operation,3 days after operation,3 months after operation and the last follow-up.And record the complications during the operation.ResultsAll patients successfully completed the operation without temporary modification of the surgical plan during the operation.The operation time of the UBE group and the open group were(147.85 ± 58.06)min and(117.81± 11.28)min,respectively.The intraoperative blood loss was(31.6± 11.58)mL and(182.19 ± 42.28)mL,the number of days in bed after surgery of the two groups were(2.00 ± 0.47)and(2.44±0.80),and the days of hospitalization were(8.25±1.90)and(11.97± 1.53),respectively.In comparative analysis,except for the operation time,the UBE group was significantly better than the open group,and it was statistically significant(P<0.05).UBE group:preoperative and postoperative JOA scores:pre-operation(9.57±2.74),3 days after operation(18.00±2.58),3 months after operation(24.79 ± 2.57),and last follow-up(26.07± 2.00).Preoperative and postoperative VAS were:pre-operation(5.29± 1.33),3 days postoperatively(3.04 ± 1.04),3 months postoperatively(1.64± 0.83),last follow-up(1.21 ± 0.57).Preoperative and postoperative ODI score:pre-operation(31.74 ± 2.22)%,3 days after operation(14.39 ± 2.54)%,after 3 months(5.48 ±1.10)%,last follow-up(3.64 ± 0.57)%.The open group:Preoperative and postoperative JOA scores:pre-operation(10.38± 2.97),3 days after surgery(14.88 ±2.93),3 months after surgery(23.31 ± 2.26),last follow-up(24.88 ± 1.70).Preoperative and postoperative VAS scores:preoperative(5.44± 1.44),3 days after operation(3.97± 1.31),3 months after operation(2.59 ± 0.84),last follow-up(1.72 ± 0.63).Preoperative and postoperative ODI scores:pre-operation(30.61±3.48)%,3 days after operation(20.98± 3.27)%,3 months after operation(7.69± 1.12)%,last followup(4.20 ± 0.92)%.Compared with the open group,the UBE group had a better clinical efficacy with statistically difference(P<0.05).Both groups of surgical patients progressed smoothly during the operation,and there were no serious complications such as infection and nerve injury after the operation.In the UBE group,there were no obvious cerebrospinal fluid leakage in the two patients with dural rupture during the operation.After conservative treatment in bed,they recovered smoothly.Before the operation,one patient with cauda equina syndrome had a slight improvement in postoperative numbness in the perineum and abnormal bowel movements.There is no significant improvement.ConclusionThe UBE-assisted lower interbody fusion technology and conventional posterior open treatment of lumbar degenerative diseases can obtain good short-term postoperative results,while patients who use UBE-assisted lower interbody fusion technology have less intraoperative blood loss.The post-recovery time is relatively short,which can effectively reduce the number of days in the hospital,and the recovery time is shorter,providing more treatment options for lumbar degenerative diseases.Moreover,the decompression process of the spinal canal,bilateral recesses and nerve root canals can be well completed during UBE operation,and the spinous process,supraspinous,interspinous ligament,articular joints and most of the lamina are preserved.Thus,the paravertebral structure is preserved to the greatest extent,and it is better than conventional open surgery in preventing postoperative low back pain.However,the operation time is slightly longer than conventional open surgery,which may be related to the initial stage of the development of this technology. |
PDF Full Text Request