Objective: To compare the efficacy of unilateral biportal endoscopy (UBE) and coaxial large channel endoscopy for lumbar spinal stenosis. Methods: A total of 176 patients with lumbar spinal stenosis treated in Tianjin Hospital from March 2015 to October 2021 were included in this study. Of the patients, 110 cases were treated with UBE, including 52 males and 58 females, with a mean age of (75.1±10.4) years; while 66 cases were treated with coaxial large channel endoscopy, including 31 males and 35 females, with an average age of (77.2±13.1) years. The visual analogue scale (VAS) score of pain and Oswestry disability index (ODI) were compared before and after surgery between the two groups, with the improvement rate calculated. The operation time, intraoperative blood loss, perioperative conditions and complications were compared. The operation efficacy was evaluated according to MacNab scale and was compared between the two groups. Results: There was no significant differences in age, gender, disease course, VAS of pain, ODI and index levels between the two groups before operation (all P>0.05). The operation time and postoperative drainage in UBE group and coaxial large channel endoscopy group were comparable [(60.1±12.4)min, (62.5±13.2)min and (103.8±20.7)ml, (98.5±22.1)ml, respectively, both P>0.05]. After the operation, the VAS score of low back pain, VAS score of leg pain and ODI of the two groups were all lower than those before operation, and decreased continuously during follow-up; and under the repeated measures analysis of variance, significant differences were found between different time points (all P<0.05), no significant difference was found between the two groups (all P>0.05), nor interaction between groups and time points was detected (all P>0.05). The patients were followed-up for (18.0±4.2) months (6 to 30 months). There was no significant difference in VAS and ODI improvement rates and excellent rate of efficacy between the two groups at the last follow-up (all P>0.05). Conclusions: Both UBE and coaxial large channel endoscopy can provide excellent results for lumbar spinal stenosis. UBE has sufficient decompression and is convenient to explore and remove the herniated disc.
目的： 对比单侧双通道内镜（UBE）技术和同轴大通道内镜对腰椎管狭窄症的治疗效果。 方法： 回顾性分析2015年3月至2021年10月在天津医院接受UBE和同轴大通道内镜治疗的176例腰椎管狭窄症患者的临床资料。其中110例采用UBE治疗，男52例，女58例，年龄（75.1±10.4）岁；66例采用同轴大通道内镜治疗，男31例，女35例，年龄（77.2±13.1）岁。比较两组手术前后疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）并计算其改善率。比较手术时间、术中出血量、围手术期情况及并发症。根据Macnab标准评定疗效并进行组间比较。 结果： 术前两组患者年龄、性别、病程、VAS、ODI和病变部位等差异均无统计学意义（均P>0.05）。UBE组和大通道组的手术时间和术后引流量分别为（60.1±12.4）min和（62.5±13.2）min、（103.8±20.7）ml和（98.5±22.1）ml，组间差异均无统计学意义（均P>0.05）。术后两组腰痛VAS评分、腿痛VAS评分以及ODI均较术前降低，且呈持续降低趋势，经重复测量设计的方差分析，不同组别间差异均无统计学意义（均P>0.05），不同时间点间差异有统计学意义（均P<0.001），组别与时间点间不存在交互作用（均P>0.05）。术后随访（18.0±4.2）个月（6~30个月），末次随访时UBE组和大通道组的腰痛和腿疼VAS改善率、ODI改善率、优良率差异均无统计学意义（均P>0.05）。 结论： UBE和同轴大通道内镜治疗腰椎管狭窄症均可获得良好疗效，UBE减压充分，容易探查摘除突出的椎间盘。.