单孔分体内镜技术在脊柱微创手术中的应用与展望

A Review of One-Hole Split Endoscopy and Its Prospectin Minimally Invasive Spine Surgery

摘要: 随着脊柱外科朝着微创化与精准化不断发展，传统脊柱内镜技术在临床应用中仍面临操作空间受限、学习曲线陡峭等挑战。单孔分体内镜技术作为新兴的微创术式，通过“单孔分体”设计，在单一通道内实现观察与操作通道的分离，兼具微创性与操作灵活性，显著改善了手术视野与器械协同能力。本文系统综述了单孔分体内镜的技术原理、系统特点及其在颈椎和腰椎疾病治疗中的临床应用。研究表明，该技术在缩短手术时间、减少术中出血、加速术后康复等方面展现出显著优势，并在长期随访中表现出良好的疼痛缓解、功能恢复及患者满意度。尽管其在脊柱稳定性维持与复杂病变处理方面仍有局限，但随着器械优化与技术标准化，单孔分体内镜有望成为脊柱微创手术的一大重要方向。未来需进一步开展大样本长期随访研究，以明确其广泛应用的可行性与有效性。

Abstract: With the ongoing trend toward minimally invasive and precision-oriented spinal surgery, conventional spinal endoscopy continues to present clinical challenges such as confined operating space and a steep learning curve. As an innovative minimally invasive approach, One-hole Split Endoscopy (OSE) adopts a “one-hole split” design that separates the viewing and working channels within a single portal, offering both minimal invasiveness and enhanced operational flexibility, while significantly improving visual field and instrument coordination. This paper provides a systematic review of the technical principles and system characteristics of one-hole split endoscopy, as well as its clinical applications in the treatment of cervical and lumbar spine disorders. Evidence indicates that this technique offers notable advantages, including shorter operative time, reduced intraoperative bleeding, and accelerated postoperative recovery, with long-term follow-up demonstrating sustained pain relief, functional improvement, and high patient satisfaction. Although limitations remain in areas such as spinal stability preservation and management of complex pathologies, ongoing instrument refinement and procedural standardization promise to establish one-hole split endoscopy as a major advance in minimally invasive spine surgery. Further large-scale, long-term follow-up studies are warranted to validate its feasibility and effectiveness for broad clinical adoption.