【摘要】 [目的]比较单侧双通道内镜（unilateral biportal endoscopy, UBE）与双侧双通道内镜（bilateral biportal endoscopy,BBE）用于Ⅰ～Ⅱ度L₅S₁椎体间融合的临床疗效。[方法]回顾性分析2021年8月—2024年1月应用内镜椎间融合治疗Ⅰ～Ⅱ度L₅S₁滑脱患者21例，Ⅰ度滑脱伴单侧下肢症状者10例采用UBE手术，Ⅰ度滑脱伴双侧下肢症状者4例及Ⅱ度滑脱7例采用BBE手术。比较两组患者临床和影像资料。[结果]所有患者均顺利完成手术，UBE组的手术时间显著长于BBE组[（178.5±22.8） min vs（139.1±17.1） min, P<0.001]，但两组术中透视次数、下地时间、住院天数的差异均无统计学意义（P>0.05）。患者均获随访，随访时间平均（12.3±3.0）个月。与术前相比，术后6个月两组腰痛和腿痛VAS评分、ODI指数均显著降低（P<0.05），相应时间点，两组间上述指标的差异均无统计学意义（P>0.05）。影像方面，与术前相比，术后6个月，两组椎间隙高度、椎管面积、滑脱率均显著改善（P<0.05）。术前两组椎间隙高度、椎管面积的差异无统计学意义（P>0.05），但UBE组滑脱率[（16.0±6.4）%vs（22.7±9.0）%, P=0.041]显著小于BBE组，末次随访，两组间上述影像指标的差异均无统计学意义（P>0.05）。UBE组滑脱复位率明显不及BBE组[（53.5±18.2）%vs（80.8±17.7）%, P=0.004]。[结论] UBE和BBE治疗Ⅰ～Ⅱ度L₅S₁滑脱可以取得安全和满意的临床疗效。相比之下，BBE的复位效果优于UBE。更多还原

【Abstract】 [Objective] To compare the clinical efficacy of unilateral biportal endoscopy（UBE） versus bilateral biportal endoscopy（BBE） for gradeⅠ/Ⅱ L₅ S₁ spondylolisthesis. [Methods] A retrospective study was done on 21 patients who had gradeⅠ/Ⅱ L₅ S₁ spondylolisthesis treated with endoscopic lumbar interbody fusion from August 2021 to January 2024. Of them, 10 patients suffered from grade I spondylolisthesis with unilateral lower limb symptoms received UBE, while other 4 patients suffered from grade I spondylolisthesis with bilateral lower limb symptoms, and 7 patients with gradeⅡspondylolisthesis underwent BBE. The clinical and imaging data of the two groups were compared. [Results] All patients in both groups had lumbar interbody fusion performed successfully. The UBE group consumed significantly longer operation time than the BBE group [（178.5±22.8） min vs（139.1±17.1） min, P<0.001]. However, there were no significant differences between the two groups in intraoperative fluoroscopy times, bed rest time and hospital stay between the two groups（P>0.05）. All patients in both group were followed up for an average of（12.3±3.0） months. Compared with those preoperatively the VAS scores for low back pain and leg pain, as well as ODI score in both groups were significantly decreased 6 months after surgery（P<0.05）, which were not statistically significant between the two groups at any time points accordingly（P>0.05）. Regarding to imaging, the vertebral space height, vertebral canal area and slippage ratio were significantly improved in both groups 6 months after surgery compared with those preoperatively（P<0.05）.There was no statistical significance in the intervertebral space height and vertebral canal area between the two groups（P>0.05）, but the slippage ratio in UBE group was significantly lower than that of BBE group before surgery [（16.0±6.4）% vs（22.7±9.0）%, P=0.041]. At the last follow-up, the UBE group was significantly inferior to the BBE group in term of slippage reduction rate [（53.5±18.2）% vs（80.8±17.7）%,P=0.004], despite of the fact that no significant differences were noted in intervertebral space height and vertebral canal area between the two groups（P>0.05）. [Conclusion] Both UBE and BBE achieve safe and satisfactory clinical consequence in the treatment of grade Ⅰ/ⅡL₅ S₁ spondylolisthesis. In contrast, BBE has better reduction capacity than UBE.更多还原