目的:本研究旨在比较单侧双向内镜(UBE)和经皮内镜(PE)减压治疗神经根型颈椎病(CSR)的临床疗效和并发症发生率。
方法:截至2024年4月,对多个数据库进行了全面的文献综述,包括EMBASE,PubMed,科克伦图书馆,中国国家知识基础设施,和万方数据,重点是比较UBE与PE在CSR后路椎间孔切开术和椎间盘切除术减压术中的临床研究。荟萃分析的重点是评估临床结果,如手术时间,失血,切口长度,颈部残疾指数(NDI)颈部疼痛和手臂疼痛的视觉模拟量表(VAS),和并发症。
结果:从电子数据库中确定的最初1,041项研究中,八人根据头衔被认为是合格的,abstract,全文筛选。这些研究涉及552名患者(269名男性,283名女性;平均年龄:53.9±11.4岁;范围,30至79岁),UBE组287人,PE组265人。Meta分析显示,UBE与PE手术时间差异无统计学意义(均差[MD]=-3.68;95%置信区间[CI]:-19.38,12.02;p=0.65)。然而,与UBE组相比,PE组的失血量(MD=17.01;95%CI:2.61,31.41;p=0.02)和切口长度(MD=11.62;95%CI:9.23,14.01;p<0.00001)均显著较低.关于临床结果,两组在NDI方面没有观察到显著差异(MD=0.12;95%CI:-0.10,0.34;0.28),颈部疼痛的VAS(MD=-0.06;95%CI:-0.19,0.06;p=0.32),手臂疼痛的VAS(MD=-0.14;95%CI:-0.26,-0.01;p=0.84),或并发症(OR=1.07;95%CI:0.54,2.10;p=0.85)。
结论:我们的研究结果表明,UBE和PE之间的临床结果没有显着差异,包括NDI,手臂疼痛的VAS,和颈部疼痛的VAS,以及并发症发生率。值得注意的是,与体育相比,治疗CSR时,UBE导致出血增加和切口长度延长,而不会大幅减少操作时间。
OBJECTIVE: This study aimed to compare the clinical efficacy and complication rates of decompression with unilateral biportal endoscopy (UBE) and percutaneous endoscopy (PE) in cervical spondylotic
radiculopathy (CSR).
METHODS: A comprehensive literature review was conducted up to April 2024 across multiple databases, including EMBASE, PubMed, Cochrane Library,
China National Knowledge Infrastructure, and Wanfang Data, focusing on clinical studies that compare UBE with PE for posterior foraminotomy and discectomy decompression in CSR. The meta-analysis was performed with an emphasis on evaluating clinical outcomes such as operation time, blood loss, incision length, Neck Disability Index (NDI), Visual Analog Scale (VAS) for neck pain and arm pain, and complications.
RESULTS: Out of an initial 1,041 studies identified from electronic databases, eight were deemed eligible based on title, abstract, and full-text screening. These studies involved 552 patients (269 males, 283 females; mean age: 53.9±11.4 years; range, 30 to 79 years), with 287 in the UBE group and 265 in the PE group. Meta-analysis indicated no significant difference in operation time between UBE and PE (mean difference [MD]=-3.68; 95% confidence interval [CI]:-19.38, 12.02; p=0.65). However, both blood loss (MD=17.01; 95% CI: 2.61, 31.41; p=0.02) and incision length (MD=11.62; 95% CI: 9.23, 14.01; p<0.00001) were significantly lower in the PE group compared to the UBE group. Regarding clinical outcomes, no significant differences were observed between the two groups in terms of NDI (MD=0.12; 95% CI:-0.10, 0.34; 0.28), VAS for neck pain (MD=-0.06; 95% CI:-0.19, 0.06; p=0.32), VAS for arm pain (MD=-0.14; 95% CI:-0.26, -0.01; p=0.84), or complications (OR=1.07; 95% CI: 0.54, 2.10; p=0.85).
CONCLUSIONS: Our findings suggest that there are no significant disparities in clinical outcomes between UBE and PE, encompassing NDI, VAS for arm pain, and VAS for neck pain, as well as complication rates. Notably, compared to PE, UBE results in increased bleeding and longer incision lengths when treating CSR, without substantially reducing operation time.