单侧双门静脉内窥镜检查后复发性腰椎间盘突出的危险因素:一项回顾性研究。

IF 2.6 3区 医学 Q2 ORTHOPEDICS
International Orthopaedics Pub Date : 2025-08-01 Epub Date: 2025-06-14 DOI:10.1007/s00264-025-06577-2
Yaoshen Zhang, Zihao Ding, Jie Wang, Li Guan, Yuzeng Liu, Yong Hai
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引用次数: 0

摘要

目的:单侧双门静脉内窥镜(UBE)是治疗LDH的一种主要的微创手术技术。尽管如此,复发性腰椎间盘突出(rLDH)仍然是UBE术后再手术的主要原因。本回顾性研究探讨了UBE术后rLDH的危险因素和再手术率。本研究旨在探讨与rLDH相关的危险因素和单节段UBE术后的再手术率。方法:回顾性分析2019年至2023年205例单水平LDH行UBE手术的患者,确定再手术原因及相关风险变量。再次手术的特点是术后放射学证据显示在同一水平持续有症状的椎间盘突出,需要进一步的手术干预。我们收集了术前和术后的放射学和人口学参数。复发性LDH患者在复发和翻修手术期间进行了额外的评估。结果:205例患者中,21例(10.2%)需要进一步的rLDH翻修手术。多因素分析表明,在控制其他潜在危险因素后,肥胖和空腹血糖水平升高是独立的危险变量,对再手术有较强的预测价值。根据受试者工作特征曲线分析,UBE的分界点为体重指数(BMI) = 25.775 kg/m2和空腹血糖(FBG) = 5.155 mmol/L。结论:肥胖(BMI为25.775 kg/m²)和空腹血糖升高(>为5.155 mmol/L)是UBE再手术的独立危险因素。因此,我们推荐更长时间的康复干预,如佩戴合适的支具和加强棘旁肌肉,对于肥胖和高FBG的患者进行UBE。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk factors for recurrent lumbar disc herniation after unilateral biportal endoscopy: a retrospective study.

Purpose: Unilateral biportal endoscopy (UBE) is a predominantly minimally invasive surgical technique for addressing LDH. Nonetheless, recurrent lumbar disc herniation (rLDH) remains the predominant reason for reoperation following UBE. This retrospective study examined the risk factors and reoperation rates for rLDH following UBE. This study aimed to examine the risk factors associated with rLDH and the reoperation rate after single-level UBE.

Methods: We retrospectively analyzed 205 patients who underwent UBE for single-level LDH from 2019 to 2023 to determine reoperation causes and related risk variables. Reoperation was characterized as the postoperative radiological evidence of persistent symptomatic disc herniation at the same level, necessitating further surgical intervention. We gathered radiographic and demographic parameters preoperatively and postoperatively. Patients with recurrent LDH had additional evaluation during recurrence and revision operations.

Results: Of the 205 patients, 21 (10.2%) required further rLDH revision surgery. The multivariate analysis indicated that obesity and elevated fasting blood glucose (FBG) levels were independent risk variables with strong predictive value for reoperation after controlling for other potential risk factors. Based on the receiver operating characteristic curve analysis, the cutoff points for UBE were body mass index (BMI) = 25.775 kg/m2 and FBG = 5.155 mmol/L.

Conclusion: This study identified obesity (BMI > 25.775 kg/m²) and elevated FBG levels (> 5.155 mmol/L) as independent risk factors for UBE reoperation. Hence, we recommend longer rehabilitation interventions, such as wearing a suitable brace and strengthening the paraspinal muscles, for patients with obesity and high FBG who undergo UBE.

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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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