双通道镜下腰椎间融合术治疗退变性腰椎疾病的手术要点和早期疗效

doi:10.13418/j.issn.1001-165x.2020.06.015

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (6): 703-708.doi: 10.13418/j.issn.1001-165x.2020.06.015

双通道镜下腰椎间融合术治疗退变性腰椎疾病的手术要点和早期疗效

梁昌详，　郑晓青，　肖丹，　黄勇兄，　梁国彦，　陈崇，　尹东，　昌耘冰

广东省医学科学院，广东省人民医院骨科中心脊柱外科，广州 510080

收稿日期:2020-09-14 出版日期:2020-11-25 发布日期:2020-12-08
通讯作者: 昌耘冰，主任医师，硕士生导师，E-mail：cspine@qq.com
作者简介:梁昌详（1982-），男，广州人，博士，副主任医师，研究方向：颈椎，微创脊柱，E-mail：lcxspine@qq.com
基金资助:
国家自然科学基金（81802217）

Surgical essentials and early clinical effects of biportal endoscopic lumbar intervertebral fusion in the treatment of degenerative lumbar disease

LIANG Chang-xiang, ZHENG Xiao-qing, XIAO Dan, HUANG Yong-xiong, LIANG Guo-yan, CHEN Chong, YIN Dong, CHANG Yun-bing

Department of Spine Surgery, Orthopedic Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences. Guangzhou 510080, Guangdong Province, China

Received:2020-09-14 Online:2020-11-25 Published:2020-12-08

摘要/Abstract

摘要： 目的　介绍双通道镜下腰椎间融合术（biportal endoscopic lumbar intervertebral fusion，BELIF）的手术要点，报道短期临床疗效及手术并发症。方法　54例患者（男性24例，女性30例，年龄38~79岁）接受BELIF术并随访3个月以上的。记录术前术后腰腿痛VAS及ODI评分。统计总手术时间，镜下操作时间，记录围手术期并发症，计算围手术期失血量，测量植骨区域占总椎间盘面积的百分比。结果　腰疼VAS评分由术前（6.13±0.64）分改善至末次随访时的（2.21±1.04）分（P<0.05），ODI评分由术前（46.54±13.75）改善至（14.78±9.23）（P<0.05）。平均手术时间164 min，平均镜下时间102 min。平均出血量为（156±31）ml。平均植骨面积（48.5±9.4）%。未出现严重并发症。结论　BELIF术短期临床疗效好，并发症少，是一种兼顾微创，安全及效率的腰椎融合手术。

关键词: 内镜辅助腰椎融合, 　腰椎退变性疾病, 　腰椎管狭窄, 　双通道内镜减压手术

Abstract: Objective　To introduce and discuss surgical highlights and advantages of BELIF (Biportal Endoscopic Lumbar Intervertebral Fusion), its short-term clinical therapeutic efficacy and potential surgical complications.　Methods　BELIF surgery was performed on 54 patients (Male: 24 cases, female: 30 cases, age: 38~79 years old) and they were followed-up at least 3 months. The VAS and ODI scores were recorded before and afer surgery. The total operation time and microscopic operation time，the perioperative complications of the patients and the perioperative bleeding volume were recorded and calculated. The percentage of bone graft area in the total intervertebral disc area was measured. Results The VAS score of low back pain improved from (6.13±0.64) before operation to (2.21±1.04) the last follow-up (P<0.05). The ODI score improved from (46.54±13.75) before operation to (14.78±9.23) (P<0.05). The average operation time was 164 min and the average endoscopic time was 102 min. The average bleeding volume was (156±31) ml. The average area of bone graft was (48.5±9.4)%. There was no serious complications. Conclusions BELIF is a minimally invasive, safe and efficient lumbar fusion surgery with good short-term clinical effect and few complications.

Key words: Endoscope-assisted lumbar fusion； , , Lumbar degenerative disease； , , Lumbar spinal canal stenosis； , , Biportal endoscopic lumbar intervertebral fusion； , , Unilateral biportal endoscopy

中图分类号:

R681.53

梁昌详, 郑晓青, 肖丹, 黄勇兄, 梁国彦, 陈崇, 尹东, 昌耘冰. 双通道镜下腰椎间融合术治疗退变性腰椎疾病的手术要点和早期疗效[J]. 中国临床解剖学杂志, 2020, 38(6): 703-708.

LIANG Chang-xiang, ZHENG Xiao-qing, XIAO Dan, HUANG Yong-xiong, LIANG Guo-yan, CHEN Chong, YIN Dong, CHANG Yun-bing. Surgical essentials and early clinical effects of biportal endoscopic lumbar intervertebral fusion in the treatment of degenerative lumbar disease[J]. Chinese Journal of Clinical Anatomy, 2020, 38(6): 703-708.

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双通道镜下腰椎间融合术治疗退变性腰椎疾病的手术要点和早期疗效

Surgical essentials and early clinical effects of biportal endoscopic lumbar intervertebral fusion in the treatment of degenerative lumbar disease

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