单侧双通道内镜下腰椎椎体间融合术与经皮单通道内镜下腰椎椎体间融合术治疗腰椎滑脱症的疗效分析

Comparison of Clinical Efficacy of UBE-LIF and PE-LIF in the Treatment of Lumbar Spondylolisthesis

摘要: 目的：探讨单侧双通道内镜下腰椎椎体间融合术与经皮单通道内镜下腰椎椎间融合术治疗腰椎滑脱症的疗效分析。方法：回顾分析新疆医科大学第六附属医院2020年6月~2023年6月收治且符合选择标准的133例单节段腰椎滑脱症患者的临床资料，根据手术方法不同，将患者分为2组：UBE-LIF组(n = 69)和PE-LIF组(n = 64)。本研究搜集两组患者的手术耗时、术中失血量等指标数据，针对患者术前、术后第3天、3个月、6个月和1年半这几个时间点的腰腿痛视觉模拟评分(Visual Analogue Scale, VAS)与Oswestry功能障碍指数(Oswestry Disability Index, ODI)予以记录，从而考量两种干预手段在疗效方面存在的差别及其临床价值。结果：所有患者手术顺利，PE-LIF组术中出血量稍多于UBE-LIF组，但两组间无明显统计学意义(175.16 ± 54.01 vs 172.90 ± 75.20 mL, P = 0.844)，UBE-LIF组手术时间较PE-LIF组少，存在统计学差异(222.38 ± 56.37 min vs 178.12 ± 41.08 min, P < 0.001)；两组术后3天、3个月、6个月、1年半的腰、腿痛VAS评分，术后3个月、6个月、末次随访的ODI评分均较术前明显改善，两组各时间点腰腿痛VAS评分、ODI评分无统计学差异(P > 0.05)。结论：两种手术均是治疗单节段腰椎滑脱安全、有效的微创方法，与PE-LIF组相比，UBE-LIF方式治疗腰椎滑脱除能获得相似椎间融合效果外，还具有手术时间短、术中视野宽阔、操作灵活等优点。

Abstract: Objectives: To compare the clinical efficacy of unilateral biportal endoscopic lumbar interbody fusion surgery and percutaneous endoscopic lumbar interbody fusion surgery in the treatment of lumbar spondylolisthesis. Methods: We conducted a retrospective analysis of the clinical data of 133 patients with single-level lumbar spondylolisthesis who met the inclusion criteria at the Sixth Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2023. Based on the different surgical approaches, patients were divided into two groups: the UBE-LIF group (n = 69) and the PE-LIF group (n = 64). The study collected intraoperative data, including operative time and blood loss of patients in both groups, and recorded the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) of low back and leg pain at the preoperative, postoperative day 3, 3 months, 6 months, and 1.5 years time points, in order to evaluate the differences in therapeutic efficacy between the two surgical techniques and their clinical value. Results: All surgeries were successfully completed. The PE-LIF group had slightly higher intraoperative blood loss than the UBE-LIF group, but there was no statistically significant difference between the two groups (175.16 ± 54.01 mL vs 172.90 ± 75.20 mL, P = 0.844), and the UBE-LIF group showed significantly shorter operative time compared to the PE-LIF group, with a statistically significant difference (178.12 ± 41.08 min vs 222.38 ± 56.37 min, P < 0.001). Both groups demonstrated significant improvement in low back and leg pain VAS scores at postoperative day 3, 3 months, 6 months, and 1.5 years, as well as in ODI scores at 3 months, 6 months, and final follow-up compared to preoperative values. No statistically significant differences were found between the two groups in low back and leg pain VAS and ODI scores at any time point (P > 0.05). Conclusions: Both surgical techniques are safe and effective minimally invasive methods for treating single-level lumbar spondylolisthesis. Compared to PE-LIF, the UBE-LIF approach in treating lumbar spondylolisthesis offers comparable interbody fusion results while providing additional advantages, including shorter operative time, a wider surgical field of view, and greater procedural flexibility.