Far Lateral Approach Surgery Under Unilateral Biportal Endoscope for Lumbar Foraminal Stenosis:Report of 39 Cases
10.3969/j.issn.1009-6604.2025.06.006
- VernacularTitle:单侧双通道内镜下远外侧入路治疗腰椎椎间孔狭窄症39例报告
- Author:
Jingwen ZHAO
1
;
Chaoliang LÜ
;
Cunxin ZHANG
;
Gongbiao LU
Author Information
1. 济宁医学院临床医学院,济宁 272013
- Publication Type:Journal Article
- Keywords:
Unilateral biportal endoscope;
Far lateral approach;
Lumbar foraminal stenosis
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(6):354-359
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of far lateral approach surgery under unilateral biportal endoscope(UBE)for lumbar foraminal stenosis.Methods From June 2021 to August 2022,39 patients with lumbar foraminal stenosis were treated with far lateral approach surgery under UBE in our department.The patients were placed at the standard prone position,and a longitudinal line was drawn about 2 cm from the lateral edge of the upper and lower pedicles.Transverse incisions were made at the two intersection points of the horizontal line at the midpoint of the lateral edge of the upper and lower pedicles.After inserting the gradually enlarged sleeves to expand the space,the enlargement of the intervertebral foramen and release of the nerve root were completed under the direct view of UBE.The Visual Analogue Scale(VAS)of leg pain and the Oswestry Disability Index(ODI)were compared before and after operation.The effectiveness was evaluated according to the modified MacNab criteria at 12 months after operation.Results The operations were successfully completed in all the 39 cases.The operation time was(105.5±14.8)min,and the blood loss was(26.7±8.8)ml.The tear of adventitial nerve root occurred in 1 case during operation,and there was no nerve injury symptom after operation.One case of suspected infection occurred after operation and recovered after conservative treatment.All the 39 patients got out of bed with waist circumference on the first day after operation.The intervertebral foramen height measured by sagittal CT at 3 d after operation was(1.62±0.26)cm,which was significantly higher than that before operation[(1.51±0.28)cm;t=-4.010,P=0.000].The intervertebral foramen width was significantly greater than preoperation[(1.24±0.17)cm vs.(0.96±0.15)cm;t=-14.811,P=0.000].The area of intervertebral foramen was significantly larger than preoperation[(1.40±0.19)cm2 vs.(1.05±0.22)cm2;t=-12.874,P=0.000].The VAS of leg pain at 1 d,and 1,3,and 6 months after operation were significantly lower than those before operation(all P=0.000),and the VAS scores gradually decreased with the increase of time.The ODI was significantly lower at 1,3,and 6 months after operation than that before operation(all P=0.000),and the ODI decreased gradually with the increase of time.According to the modified MacNab criteria,at 12 months after operation,33 cases were excellent,4 cases were good,and 2 cases were fair,with an excellent and good rate of 94.9％(37/39).Conclusions Far lateral approach surgery under UBE for lumbar foraminal stenosis has significant effect on the relief of lumbago and leg pain and the improvement of lumbar function.It has little damage to lumbar stability and does not need internal fixation,which is worthy of clinical application and promotion.
