| Objective To evaluate the clinical value of unilateral fixation and fusion assisted by unilateral biportal endoscopy in the treatment of lumbar degenerative diseases. Methods A retrospective analysis was conducted on the clinical data of 50 patients with lumbar degenerative diseases who underwent unilateral pedicle screw fixation surgery at Orthopedic Hospital of Xingtai from January 2020 to December 2024. The patients were divided into groups based on the different surgical methods. Among them, 25 cases with unilateral double-channel endoscopic-assisted surgery were classified as the study group(UBE group), and 25 cases with minimally invasive transforaminal lumbar interbody fusion surgery were classified as the control group(MIS-TLIF group). The general basic information of the two groups of patients, including gender, age, surgical segments, postoperative hospital stay, operation time, and intraoperative blood loss, were recorded. The visual analogue scale was used to evaluate low back and leg pain, and the Oswestry Disability Index was used to evaluate the limitation of daily living ability. The intervertebral fusion was evaluated according to the Bridwell fusion evaluation grading standard, and the clinical efficacy was evaluated by the modified MacNab standard. The intervertebral space height, lumbar lordosis angle, and lordosis angle of the surgical segment of the lumbar spine were measured before surgery and at the last follow-up. The bony fusion of the intervertebral space was evaluated based on the lumbar X-ray and CT images at the last follow-up. The data before surgery, after surgery, and at the last follow-up of the two groups were compared and analyzed. Results The operation time and postoperative hospital stay of the study group were shorter than those of the control group, and the postoperative drainage volume was lower than that of the control group, with statistically significant differences(P < 0.05). The postoperative pain of both groups was relieved in a time-dependent manner(P < 0.05). Compared with the control group, the pain of the study group improved more significantly over time, and there was an interaction effect(P < 0.05). The postoperative living ability of both groups was improved in a time-dependent manner(P< 0.05), but without interaction effect(P> 0.05). At the last follow-up, the efficacy evaluation showed that in the study group, 23 cases were excellent and 2 cases were good, with an excellent and good rate of 92%(23/25); in the control group, 22 cases were excellent and 3 cases were good, with an excellent and good rate of 88%(22/25). Regarding intervertebral bone graft fusion, in the study group, 14 cases were grade Ⅰ, 7 cases were grade Ⅱ, and 4 cases were grade Ⅲ, with a fusion rate of 84%; in the control group, 18 cases were grade Ⅰ, 5 cases were grade Ⅱ, and 2 cases were grade Ⅲ, with a fusion rate of 92%. The average intervertebral space height, lumbar lordosis angle, and lordosis angle of the surgical segment of both groups were significantly improved compared with those before the operation(P < 0.05), but there was no significant difference between the two groups(P > 0.05). Conclusion Unilateral fixation fusion surgery is safe and effective in treating lumbar degenerative diseases. Compared with the open surgical method, the UBE technique shows better performance in terms of operation time, postoperative drainage volume, and postoperative hospital stay, which is conducive to the rapid recovery of patients after surgery. |
