The application value of neuroelectrophysiological monitoring in unilateral dual-channel endoscopic decompression for patients with lumbar degenerative diseases

WANG Xiaogang; LIU Mingjun; NIE Haibin

doi:10.3969/j.issn.1674-666X.2025.05.004

Abstract：Objective To explore the application value of neuroelectrophysiological monitoring in unilateral bioportal endoscopic(UBE)decompression for patients with lumbar degenerative diseases.Methods A prospective single-blind randomized clinical trial was conducted on 103 patients with lumbar degenerative diseases who underwent UBE decompression surgery at Puyang People's Hospital from June 2022 to June 2024.Among them,52 cases were included in the monitoring group(with neuroelectrophysiological monitoring during the operation),and 51 cases were included in the control group(without neuroelectrophysiological monitoring during the operation).The surgical indicators of the two groups of patients were observed.Low back and leg pain,neurological function,spinal cord function and pain mediators in two groups were compared before and after the surgery.Results There was no statistical differences in surgical indicators(operation time,intraoperative fluoroscopy frequency,blood loss,postoperative drainage volume and total hospital stay),preoperative visual analogue scale(VAS)score for low back and leg pain and Oswestry disability index(ODI),as well as preoperative levels of serum nitric oxide(NO),substance P(SP),β-endorphin(β-EP),and prostaglandin E2(PGE2)between the two groups(all P>0.05).At 1,3,6 and 12 months after the operation,the VAS scores and ODI of the two groups of patients were significantly improved compared with those before the operation,and the VAS scores and ODI of the monitoring group at different time points after the operation were lower than those of the control group(all P<0.05).Three days after the operation,the levels of serum NO,SP,β-EP and PGE2 in both groups decreased,and the levels of the above pain mediator indicators in the monitoring group were all lower than those in the control group(all P<0.05).During the follow-up period,1 case of incision infection and 1 case of pulmonary infection occurred in the monitoring group,while 2 cases of nerve root injury,1 case of intervertebral space infection,1 case of incision infection and 2 cases of pulmonary infection occurred in the control group.There was no statistical difference in the incidence of complications between the two groups(3.85%vs 11.76%,P>0.05).Conclusion For patients with lumbar degenerative diseases who undergo UBE decompression surgery,the application of neuroelectrophysiological monitoring during the operation can reduce the risk of nerve root injury,improve surgical safety,and provide favorable conditions for improving the levels of pain mediators,alleviating low back and leg pain,and promoting the recovery of nerve function after the operation.