En bloc resection of the ligamentum flavum for bilateral decompression in unilateral biportal endoscopic transforaminal lumbar interbody fusion: a 2-year follow-up study.

IF 2.8 3区 医学 Q1 ORTHOPEDICS
Chao Li, Beiyu Xu, Yao Zhao, Longtao Qi, Lei Yue, Ranlyu Zhu, Chunde Li, Zhengrong Yu
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Abstract

Background: Unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) is a minimally invasive procedure for treating lumbar degenerative diseases. However, the use of endoscopic lumbar interbody fusion does not completely eliminate the risk of dural and nerve root injuries. This study has refined UBE-TLIF to incorporate en bloc resection of the ligamentum flavum for bilateral decompression and aim to detail the surgical procedure and evaluate the clinical outcomes of this modification.

Methods: This study analyzes the outcomes of 109 consecutive patients treated by a single surgeon for lumbar degenerative disease using UBE-TLIF. Patients were divided into two groups: Group A (51 patients) underwent en bloc resection of the ligamentum flavum, while Group B (58 patients) underwent routine piecemeal resection. Assessed outcomes included surgery-related complications, operation time, estimated blood loss, postoperative stay, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). The surgical technique is detailed within the study.

Results: In Group A, no nerve root or dura injuries were observed, whereas Group B reported one case of nerve root injury and three dura tears. The average operation time for Group A was shorter than that for Group B; however, the difference was not statistically significant (P > 0.05). No significant differences were found in the VAS score, ODI, estimated blood loss, or postoperative stay between the groups during follow-up.

Conclusions: En bloc resection of the ligamentum flavum for bilateral decompression in UBE-TLIF demonstrates satisfactory clinical outcomes and low perioperative complications rates, offering a safe and innovative alternative for the treatment of lumbar degenerative disease.

单侧双门静脉内镜下经椎间孔腰椎椎间融合术中黄韧带整体切除双侧减压:一项2年随访研究。
背景:单侧双门静脉内镜下经椎间孔腰椎椎体间融合术(UBE-TLIF)是一种治疗腰椎退行性疾病的微创手术。然而,使用内窥镜腰椎椎体间融合术并不能完全消除硬脑膜和神经根损伤的风险。本研究改进了UBE-TLIF,将黄韧带整体切除术纳入双侧减压,旨在详细介绍手术程序并评估这种改良的临床结果。方法:本研究分析了109例连续由一名外科医生使用UBE-TLIF治疗腰椎退行性疾病的患者的结果。患者分为两组:A组(51例)行黄韧带整体切除,B组(58例)行常规部分切除。评估结果包括手术相关并发症、手术时间、估计失血量、术后住院时间、视觉模拟评分(VAS)评分和Oswestry残疾指数(ODI)。研究中详细介绍了手术技术。结果:A组无神经根、硬脑膜损伤,B组1例神经根损伤,3例硬脑膜撕裂。A组平均手术时间短于B组;但差异无统计学意义(P < 0.05)。随访期间,两组间的VAS评分、ODI、估计失血量或术后停留时间均无显著差异。结论:UBE-TLIF双侧减压黄韧带整体切除临床效果满意,围手术期并发症发生率低,为腰椎退行性疾病的治疗提供了一种安全创新的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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