单侧双通道脊柱内镜技术与经皮椎间孔脊柱内镜技术治疗腰椎间盘突出症的临床效果与影像学指标对比研究OA

Objective To compare the clinical effects and radiological parameters of unilateral biportal endoscopy(UBE)and percutaneous endoscopic lumbar discectomy(PELD)in the treatment of lumbar disc herniation(LDH).Methods The clinical data of 30 patients with LDH who underwent minimally invasive surgery at Baiyin Hospital of Integrated Traditional Chinese and Western Medicine and Jingtai County Hospital of Traditional Chinese Medicine from June 2020 to December 2024 were retrospectively analyzed.They were divided into the PELD group and the UBE group according to the surgical procedure.The surgical efficacy,perioperative indicators,pain intensity,lumbar function,radiological parameters and occurrence of complications were compared between the two groups.Results At 12 months after surgery,there was no statistically significant difference in the excellent and good rate between the two groups(P＞0.05).Compared with the PELD group,the UBE group had significantly longer incision length,more intraoperative blood loss,more intraoperative resection volume of ligamentum flavum and bone tissue,larger intraoperative decompression range,and shorter intraoperative duration of nerve root traction and operation time(P＜0.05).At 1 month and 12 months after surgery,the Visual Analogue Scale(VAS)score and Oswestry Disability Index(ODI)of both groups were significantly lower than those before surgery,and the Japanese Orthopaedic Association 29-point Score(JOA-29)was significantly higher than that before surgery(P＜0.05);however,there was no statistically significant difference between the groups(P＞0.05).At 12 months after surgery,the cross-sectional area of the dural sac in the UBE group was significantly higher than that in the PELD group,while the intervertebral disc height and spinal canal occupation rate were significantly lower than those in the PELD group(P＜0.05);no statistically significant difference was found in lumbar lordosis(LL),lumbar alignment(LA)and L1 tilt(L1T)between the groups,but statistically significant difference was found within each group(P＜0.05).The total incidence of postoperative complications in both groups was 13.33％(2/15),with no statistically significant difference(P＞0.05).Conclusions Both UBE and PELD are safe and effective for the treatment of LDH,with comparable short-to-medium-term efficacy at 12 months after surgery.UBE provides more thorough decompression and lower risk of nerve injury in complex LDH,while PELD causes less trauma and allows faster recovery.The surgical procedure should be individually selected according to the type of disc herniation and comorbidities in clinical practice.