【摘要】 [目的]探讨改良单侧双通道内镜下椎间盘切除术（unilateral biportal endoscopic discectomy, UBED）治疗腰椎间盘突出症（lumbar disc herniation, LDH）的临床疗效。[方法]回顾性分析2021年1月—2022年12月本科收治的108例LDH患者的临床资料，所有患者均采用改良UBED手术治疗，术中使用自制管状通道维持操作通道。评价临床及影像结果。[结果]本组病例手术时间平均（63.0±11.7）min，术后卧床时间平均（10.3±1.9）h。共6例出现了术中或术后并发症，包括2例硬膜损伤、1例硬膜外血肿、2例短暂性感觉障碍和1例腰椎间盘突出症复发。患者均获1年以上随访，与术前相比，术后3、12个月的腰痛VAS[分,(4.4±0.9),(1.7±0.6),(1.5±0.6), P<0.001]、下肢痛VAS[分,(7.4±1.3),(1.7±0.6),(1.2±0.7), P<0.001]、ODI[%,(46.2±7.6),(16.9±5.1),(14.8±3.9), P<0.001]和JOA评分[分,(14.9±2.8),(23.1±3.2),(26.1±3.1),P<0.001]均显著改善。影像方面，与术前相比，术后椎管占位率显著降低（P<0.05），而椎间隙高度和腰椎前凸角无显著改变（P>0.05）。[结论]通过改良UBED治疗LDH安全有效。更多还原

【Abstract】 [Objective] To explore the clinical efficacy of modified unilateral biportal endoscopic discectomy(UBED) in the treatment of lumbar disc herniation(LDH). [Methods] A retrospective analysis was conducted on 108 patients who had LDH treated with the modified UBED in our department from January 2021 to December 2022. The modification of UBE involved maintain the operating field during the operation with a self-made tubular channel. The clinical and imaging data were evaluated. [Results] All the 108 patients had the modified UBED performed smoothly with the average operation time of(63.0±11.7) min and the average postoperative bed rest time of(10.3±1.9)hours, except intraoperative or postoperative complications happened in 6 cases, including 2 cases of dural injury, 1 case of epidural hematoma, 2 cases of transient sensory impairment and 1 case of recurrence of lumbar intervertebral disc protrusion. All patients were followed up for more than one year. With time elapsed preoperatively, 3 and 12 months after operation, the back pain VAS score [points,(4.4 ±0.9),(1.7±0.6),(1.5±0.6), P<0.001], lower limb pain VAS [points,(4.4±0.9),(1.7±0.6),(1.5±0.6), P<0.001], leg pain VAS score [points,(7.4±1.3),(1.7±0.6),(1.2±0.7), P<0.001], ODI score [%,(46.2±7.6),(16.9±5.1),(14.8±3.9), P<0.001] and JOA score [points,(14.9±2.8),(23.1±3.2),(26.1±3.1), P<0.001] were improved significantly. In regard of imaging, the spinal canal occupied ratio was decreased significantly after the operation compared with that before the operation(P<0.05), whereas the intervertebral space height and the lumbar lordosis angle remained unchanged significantly(P>0.05). [Conclusion] The modified UBED is safe and effective surgical technique for LDH.更多还原