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. 2025 Jan 15;39(1):83-87.
doi: 10.7507/1002-1892.202409030.

[Short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery via crossing midline approach in treatment of free lumbar disc herniation]

[Article in Chinese]
Zhongfeng Li  1 , Yandong Liu  2 , Lipeng Wen  2 , Bo Chen  2 , Ying Yang  3 , Yurong Wang  1 , Randong Peng  1 , En Song  4
Affiliations

[Short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery via crossing midline approach in treatment of free lumbar disc herniation]

[Article in Chinese]
Zhongfeng Li et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. .

Abstract
in English, Chinese

Objective: To investigate the short-term effectiveness of uni-portal non-coaxial spinal endoscopic surgery (UNSES) via crossing midline approach (CMA) in the treatment of free lumbar disc herniation (FLDH).

Methods: Between March 2024 and June 2024, 16 patients with FLDH were admitted and treated with UNSES via CMA. There were 9 males and 7 females with an average age of 55.1 years (range, 47-62 years). The disease duration was 8-30 months (mean, 15.6 months). The pathological segments was L 3, 4 in 4 cases, L 4, 5 in 5 cases, and L 5, S 1 in 7 cases. The preoperative pain visual analogue scale (VAS) score was 6.9±0.9 and the Oswestry disability index (ODI) was 57.22%±4.16%. The operation time, intraoperative bleeding volume, postoperative hospital stay, and incidence of complications were recorded. The spinal pain and functional status were evaluated by VAS score and ODI, and effectiveness was evaluated according to the modified MacNab criteria. CT and MRI were used to evaluate the effect of nerve decompression.

Results: All 16 patients underwent operation successfully without any complications. The operation time was 63-81 minutes (mean, 71.0 minutes). The intraoperative bleeding volume was 47.3-59.0 mL (mean, 55.0 mL). The length of hospital stay after operation was 3-4 days (mean, 3.5 days). All patients were followed up 1-3 months, with 15 cases followed up for 2 months and 14 cases for 3 months. The VAS score and ODI gradually decreased over time after operation, and there were significant differences between different time points ( P<0.05). At 3 months after operation, the effectiveness was rated as excellent in 12 cases and good in 2 cases according to the modified MacNab criteria, with an excellent and good rate of 100%. CT and MRI during follow-up showed a significant increase in the diameter and cross-sectional area of the spinal canal, indicating effective decompression of the canal.

Conclusion: When using UNSES to treat FLDH, choosing CMA for nerve decompression has the advantages of wide decompression range, large operating space, and freedom of operation. It can maximize the preservation of the articular process, avoid fracture and breakage of the isthmus, clearly display the exiting and traversing nerve root, and achieve good short-term effectiveness.

目的: 探讨采用单孔非同轴脊柱内镜（uni-portal non-coaxial spinal endoscopic surgery，UNSES）经跨棘突入路（crossing midline approach，CMA）治疗游离型腰椎间盘突出症（free lumbar disc herniation，FLDH）的早期疗效。.

方法: 2024年3月—6月，采用UNSES经CMA治疗16例FLDH患者。男9例，女7例；年龄47～62岁，平均55.1岁。病程8～30个月，平均15.6个月。病变节段：L 3、4 4例，L 4、5 5例，L 5、S 1 7例。术前疼痛视觉模拟评分（VAS）为（6.9±0.9）分，Oswestry功能障碍指数（ODI）为57.22%±4.16%。记录手术时间、术中出血量、术后住院时间以及相关并发症发生情况。术后采用VAS评分及ODI评价脊柱疼痛及功能情况，按照改良MacNab标准评价临床疗效；CT和MRI复查评价神经减压效果。.

结果: 16例患者手术均顺利完成，无手术相关并发症发生。手术时间63～81 min，平均71.0 min；术中出血量47.3～59.0 mL，平均55.0 mL；术后住院时间3～4 d，平均3.5 d。患者均获随访，随访时间1～3个月，其中随访达2个月15例、3个月14例。术后随时间延长VAS评分及ODI均逐渐降低，手术前后各时间点间比较差异均有统计学意义（ P<0.05）。术后3个月，改良MacNab疗效评价达优12例、良2例，优良率达100%。随访期间影像学复查示椎管直径和横截面积明显增加，椎管有效减压。.

结论: 采用UNSES治疗FLDH时，选择CMA进行神经减压具有减压范围广、操作空间大以及操作自由等优势，可最大限度地保留关节突，避免峡部骨折断裂，清晰显示出口神经根和行走神经根，获得较好早期疗效。.

Keywords: Uni-portal non-coaxial spinal endoscopic surgery; crossing midline approach; free lumbar disc herniation; short-term effectiveness.

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Conflict of interest statement

利益冲突 在课题研究和文章撰写过程中不存在利益冲突；经费支持没有影响文章观点和对研究数据客观结果的统计分析及其报道

Figures

图 1
图 1
Surgical operation diagram 手术操作示意图
图 2
图 2
A 48-year-old female patient with FLDH at L5, S1 患者，女，48岁，L5、S1 FLDH
See this image and copyright information in PMC

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References

    1. Zhu X, Zhao Y, Liu K, et al Clinical outcomes of fenestration discectomy and iLESSYS-Delta interlaminar endoscopic system for treatment of LDH: a single-center retrospective cohort study. Sci Rep. 2024;14(1):20087. doi: 10.1038/s41598-024-70973-8. - DOI - PMC - PubMed
    1. Soares RO, Astur N, Rabello de Oliveira L, et al Qualitative evaluation of paraspinal musculature after minimally invasive lumbar decompression: a prospective study. Int J Spine Surg. 2024;18(4):448–454. doi: 10.14444/8631. - DOI - PMC - PubMed
    1. Peng CH, Chen IH, Yu TC, et al Risk factors for reoperation after discectomy of lumbar herniated intervertebral disc disease. Tzu Chi Med J. 2024;36(3):298–303. doi: 10.4103/tcmj.tcmj_206_23. - DOI - PMC - PubMed
    1. Pruna VM, Miron I, Visarion DM, et al Full endoscopic surgery for lumbar disc herniation using the interlaminar approach: principles and complications. Neurol India. 2024;72(3):492–496. doi: 10.4103/neurol-india.Neurol-India-D-24-00066. - DOI - PubMed
    1. Pokorny G, Amaral R, Marcelino F, et al Minimally invasive versus open surgery for degenerative lumbar pathologies: a systematic review and meta-analysis. Eur Spine J. 2022;31(10):2502–2526. doi: 10.1007/s00586-022-07327-3. - DOI - PMC - PubMed

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