关键词: 腰椎间盘突出症； 经皮脊柱内镜下腰椎间盘切除术； 单通道； 单侧双通道；疗效

Abstract: Objective To compare the clinical curative effect of percutaneous endoscopic lumbar discectomy (PELD) and unilateral biportal endoscopic discectomy (UBED) on lumbar disc herniation (LDH).Methods A retrospective analysis was performed on the case data of 102 patients with LDH undergoing percutaneous endoscopic lumbar discectomy in the hospital between June 2019 and June 2022,including 51 cases undergoing PELD in PELD group and 51 cases undergoing UBED in UBED group.The operation time,intraoperative blood loss,hospitalization time and other surgical related indicators,postoperative spinal canal cross-sectional area,sagittal diameter of intervertebral foramen,intervertebral foramen area and other imaging indicators,visual analogue scale (VAS),Oswestry disability index (ODI) and surgical efficacy were compared between the two groups.The complications such as dural tear and hematoma were recorded in the two groups.Results The operation time,postoperative bed time and hospitalization time in PELD group were similar to those in UBED group(P>0.05).The times of intraoperative fluoroscopy in PELD group were more than those in UBED group [(6.62±1.11) times vs. (3.24±0.72) times],and intraoperative blood loss was less than that in UBED group [(21.56±4.79) ml vs. (38.59±7.82) ml;P<0.05].After surgery,VAS and ODI scores in both groups were decreased (P<0.05).After surgery,imaging indexes (cross-sectional area of spinal canal,sagittal diameter in the middle of intervertebral foramen,intervertebral foramen area) in both groups were significantly improved (P<0.05),but the PELD group were similar to those in UBED group (P>0.05).The good rates of surgery in both groups were high,but the PELD group were similar to those in UBED group (P>0.05).The incidence of surgical related complications in PELD group were similar to those in UBED group (Fisher exact probability=1.000).Conclusion The clinical curative effect of PELD and UBED is comparable on LDH.However,the former has less intraoperative blood loss,while the latter has fewer times of intraoperative fluoroscopy and less radiation.

Key words: lumbar disc herniation; percutaneous endoscopic lumbar discectomy; single channel; unilateral double channel; curative effect