Comparison of the clinical efficacy of full-endoscopic large-channel interbody decompression and fusion with unilateral versus bilateral pedicle-screw fixation in the treatment of lumbar degenerative disease

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-05-01 Epub Date: 2026-02-11 DOI:10.1016/j.jor.2026.02.045

Yukai Cui , Haoran Zhang , Xiaohao Sun , Junliang Xu , Wen Yin , Xilong Cui , Wei Jiao

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Abstract

Background

Comparison of the clinical efficacy of full-endoscopic large-channel interbody decompression and fusion combined with unilateral versus bilateral pedicle-screw fixation in the treatment of single-level lumbar degenerative disease.

Methods

We conducted a retrospective analysis of the clinical data of 56 patients with single-level lumbar degenerative disease who underwent full-endoscopic large-channel interbody decompression, fusion, and internal fixation surgery at our hospital. Among them, 26 patients underwent unilateral pedicle screw fixation (UPSF), and 30 patients underwent bilateral pedicle screw fixation (BPSF).The comparison included the following parameters: surgical time, intraoperative fluoroscopy frequency, hospitalization costs, length of hospital stay, changes in hemoglobin levels before and after surgery, and complication rates. Preoperative and postoperative pain were assessed using the Visual Analog Scale (VAS) at 3 days, 3 months, and 1 year. Functional disability was evaluated using the Oswestry Disability Index (ODI) at preoperative, 3-month, and 1-year follow-ups. One year post-surgery, interbody fusion was evaluated by CT, and clinical outcomes were assessed using the modified MacNab criteria.

Results

The surgical time, intraoperative fluoroscopy frequency, hospitalization costs, and length of hospital stay were significantly higher in the BPSF group compared to the UPSF group (P < 0.05). There was no statistical difference in the changes in hemoglobin levels between the two groups postoperatively (P > 0.05). The VAS scores at 3 days, 3 months, and 1 year, as well as the ODI scores at 3 months and 1 year, were significantly lower than preoperative values in both groups (P < 0.05). However, there were no significant differences in the VAS and ODI scores at the same time points between the two groups (P > 0.05). The complication rates, fusion rates at 1 year, and the excellent rate according to the modified MacNab criteria were not significantly different between the two groups (P > 0.05).

Conclusions

The treatment of single-segment lumbar degenerative disease using a large-channel full-endoscopic intervertebral decompression and fusion combined with UPSF is safe and effective. Compared with BPSF group, UPSF group has advantages in terms of fewer fluoroscopy times, shorter surgical duration, lower hospitalization costs, and shorter hospital stays.

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全内镜下大通道椎体间减压融合单侧与双侧椎弓根螺钉固定治疗腰椎退行性疾病的临床疗效比较

背景：全内镜下大通道椎间减压融合联合单侧与双侧椎弓根螺钉固定治疗单节段腰椎退行性疾病的临床疗效比较。方法回顾性分析56例在我院行全内镜下大通道椎间减压融合内固定手术的单节段腰椎退行性疾病患者的临床资料。其中单侧椎弓根螺钉固定（UPSF） 26例，双侧椎弓根螺钉固定（BPSF） 30例。比较的参数包括：手术时间、术中透视次数、住院费用、住院时间、手术前后血红蛋白水平变化、并发症发生率。术前和术后疼痛分别在3天、3个月和1年采用视觉模拟评分（VAS）进行评估。术前、3个月和1年随访时采用Oswestry功能障碍指数（ODI）评估功能障碍。术后1年，通过CT评估体间融合，并使用改良的MacNab标准评估临床结果。结果BPSF组手术时间、术中透视次数、住院费用、住院时间均显著高于UPSF组（P < 0.05）。两组术后血红蛋白水平变化比较，差异无统计学意义（P > 0.05）。两组患者3天、3个月、1年的VAS评分及3个月、1年的ODI评分均显著低于术前（P < 0.05）。两组患者同一时间点的VAS和ODI评分比较，差异无统计学意义（P > 0.05）。两组并发症发生率、1年融合率、改良MacNab标准优良率比较，差异均无统计学意义（P > 0.05）。结论大通道全内镜下椎间减压融合术联合UPSF治疗单节段腰椎退行性疾病安全有效。与BPSF组相比，UPSF组在透视次数少、手术时间短、住院费用低、住院时间短等方面具有优势。

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

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.