单侧双通道内镜与通道显微内镜治疗腰椎管狭窄症的meta分析

doi:10.3877/cma.j.issn.2096-0263.2023.03.007

目的

通过Meta分析比较单侧双通道内镜手术（UBES）与通道显微内镜手术（TMS）安全性及有效性的差异。

方法

计算机检索在Embase、Pubmed、Central、Cinahl、PQDT、Cochrane Library、CBM、CNKI等数据库公开发表的单侧双通道内镜手术和显微内镜手术治疗腰椎管狭窄症的文献，依据检索策略，共检索到相关文献784篇，并最终纳入14篇文献。对文献依据Cochrane系统评价方法学进行质量评价，提取数据后，用RevMan 5.4软件进行Meta分析。

结果

通过比较发现，UBES治疗腰椎管狭窄症时，在术后VAS下肢痛评分在术后1周内[95% CI：-1.05，-0.37，P<0.001]、术后VAS腰痛评分在术后1周内[95% CI：-1.77，-1.14，P<0.001]、术后ODI评分在术后1~3月[95% CI：-2.06，-0.05，P=0.04]、术后离床活动时间[95% CI：-12.09，-6.43，P<0.001]、住院时间[95% CI：-6.63，-1.09，P=0.006]、术中出血量[95% CI：-112.12，-36.37，P<0.001]及术后优良率（改良Macnab标准）[95% CI：1.05，3.46，P=0.04]评定上均优于TMS组。而两组手术方式在术后1周~1个月、术后1~3个月的下肢痛VAS评分和腰痛VAS评分，术后1月内ODI评分，手术时间及术后总并发症的结果差异均无统计学意义。

结论

在治疗腰椎管狭窄时，相较于TMS组，UBES组术后具有更短的住院时间、更早的离床活动时间、更少的出血量及更优的疼痛症状改善。

关键词: 腰椎管狭窄症, 单侧双通道内镜技术, 通道显微内镜技术, Meta分析

Objective

This meta-analysis compared the safety and efficacy of unilateral biportal endoscopic surgery (UBES) and tubular microendoscopic surgery (TMS).

Methods

Computer searches were performed on Embase, PubMed, Central, Cochrane Library, CNKI, and Wanfang databases for published literature on UBES and TMS in lumbar spinal stenosis. A total of 784 related studies were retrieved, and 14 were finally included. Literature quality was evaluated using the Cochrane systematic review methodology. After data extraction, a meta-analysis was performed using the ReviewManager 5.4 software.

Results

By comparison, UBES for lumbar spinal stenosis was found to be associated with postoperative VAS lower extremity pain scores at 1 week postoperatively [95% CI: -1.05, -0.37, P<0.001], postoperative VAS low back pain scores at 1 week postoperatively [95% CI: -1.77, -1.14, P<0.001], postoperative ODI scores at 1-3 months postoperatively [95% CI: -2.06, -0.05, P=0.04], postoperative time out of bed [95% CI: -12.09, -6.43, P<0.001], hospital stay [95% CI: -6.63, -1.09, P=0.006], intraoperative bleeding [95% CI: -112.12, -36.37, P<0.001] and postoperative excellent rate (modified Macnab criteria) [95% CI: 1.05, 3.46, P=0.04] were rated better than the TMS group. In contrast, there was no significant difference between the two surgical approaches in the outcomes of lower extremity pain VAS scores and low back pain VAS scores at 1 week to 1 month and 1 to 3 months post-surgery, ODI scores at 1 month post-surgery, time to surgery and total post-surgery complications.

Conclusion

In the treatment of lumbar stenosis, the UBES group had a shorter hospital stay, an earlier time out of bed, less bleeding, and a better improvement in pain symptoms than the TMS group.

Key words: Lumbar Spinal Stenosis, Unilateral biportal endoscopic, Tubular microendoscopic, Meta-analysis

图1 文献筛选流程图

表1 纳入文献研究基本特征表

作者	研究设计方法	国家	年份	组别	患者例数	年龄（岁，±s）	性别（男/女）	纳入指标	纽卡斯尔-渥太华量表
Aygun等^[8]	Prospective	沙特阿拉伯Saudi Arabia	2021	UBES	77	64.64±10.09	44/33	⑻	9
Aygun等^[8]	Prospective	沙特阿拉伯Saudi Arabia	2021	TMS	77	65.01±9.24	50/27	⑻	9
Carrascosa-Granada等^[9]	Prospective	西班牙Spain	2020	UBES	10	73.5±10.51	4/6	⑴⑵⑶⑷⑺	8
Carrascosa-Granada等^[9]	Prospective	西班牙Spain	2020	TMS	10	69.7±8.64	4/6	⑴⑵⑶⑷⑺	8
Gatam等^[10]	Retrospective	印度尼西亚Indonesia	2021	UBES	72	55.1±5.12	26/46	⑵	7
Gatam等^[10]	Retrospective	印度尼西亚Indonesia	2021	TMS	73	52.3±6.13	28/45	⑵	7
Heo等^[11]	Prospective	韩国Korea	2018	UBES	46	65.8±8.9	18/28	⑴⑵⑶⑺	7
Heo等^[11]	Prospective	韩国Korea	2018	TMS	42	63.6±10.5	16/26	⑴⑵⑶⑺	7
Hua等^[12]	Retrospective	中国China	2020	UBES	32	56.7±9.1	12/20	⑴⑵⑶⑷⑸⑹⑺⑻	8
Hua等^[12]	Retrospective	中国China	2020	TMS	80	58.8±10.5	32/48	⑴⑵⑶⑷⑸⑹⑺⑻	8
Ito等^[13]	Retrospective	日本Japan	2021	UBES	42	66.3±12.3	28/14	⑶⑺	7
Ito等^[13]	Retrospective	日本Japan	2021	TMS	139	65.0±11.1	71/68	⑶⑺	7
Kang等^[14]	Prospective	韩国Korea	2019	UBES	32	65.1±8.6	18/14	⑶⑺⑻	7
Kang等^[14]	Prospective	韩国Korea	2019	TMS	30	67.2±9.5	14/16	⑶⑺⑻	7
Kim等^[15]	Retrospective	韩国Korea	2021	UBES	32	70.5±8.26	17/15	⑴⑵⑶⑸⑹⑺⑻	7
Kim等^[15]	Retrospective	韩国Korea	2021	TMS	55	67.3±10.7	25/30	⑴⑵⑶⑸⑹⑺⑻	7
Min等^[16]	Retrospective	韩国Korea	2019	UBES	54	65.74±10.52	27/27	⑴⑵⑶⑸⑹⑺	8
Min等^[16]	Retrospective	韩国Korea	2019	TMS	35	66.74±7.96	19/16	⑴⑵⑶⑸⑹⑺	8
赵子豪等^[17]	Retrospective	中国China	2021	UBES	34	65.71±10.55	16/18	⑴⑵⑶⑸⑹	7
赵子豪等^[17]	Retrospective	中国China	2021	TMS	31	66.53±8.17	15/16	⑴⑵⑶⑸⑹	7
庹伟等^[18]	Retrospective	中国China	2021	UBES	22	59.1±11.7	12/10	⑴⑵⑷⑺	7
庹伟等^[18]	Retrospective	中国China	2021	TMS	25	58.3±8.7	11/14	⑴⑵⑷⑺	7
Choi等^[19]	Retrospective	韩国Korea	2019	UBES	35	65.4±11.8	14/21	⑴⑺	7
Choi等^[19]	Retrospective	韩国Korea	2019	TMS	30	65.2±12.0	17/13	⑴⑺	7
Heo等^[20]	Prospective	韩国Korea	2019	UBES	37	66.7±9.4	15/22	⑴⑵⑶⑺	7
Heo等^[20]	Prospective	韩国Korea	2019	TMS	33	63.4±11.1	12/21	⑴⑵⑶⑺	7
Park等^[21]	Prospective	韩国Korea	2019	UBES	32	NA	13/19	⑴⑵⑶⑹⑺	8
Park等^[21]	Prospective	韩国Korea	2019	TMS	32	NA	18/14	⑴⑵⑶⑹⑺	8

表1 纳入文献研究基本特征表

作者	研究设计方法	国家	年份	组别	患者例数	年龄（岁，±s）	性别（男/女）	纳入指标	纽卡斯尔-渥太华量表
Aygun等^[8]	Prospective	沙特阿拉伯Saudi Arabia	2021	UBES	77	64.64±10.09	44/33	⑻	9
Aygun等^[8]	Prospective	沙特阿拉伯Saudi Arabia	2021	TMS	77	65.01±9.24	50/27	⑻	9
Carrascosa-Granada等^[9]	Prospective	西班牙Spain	2020	UBES	10	73.5±10.51	4/6	⑴⑵⑶⑷⑺	8
Carrascosa-Granada等^[9]	Prospective	西班牙Spain	2020	TMS	10	69.7±8.64	4/6	⑴⑵⑶⑷⑺	8
Gatam等^[10]	Retrospective	印度尼西亚Indonesia	2021	UBES	72	55.1±5.12	26/46	⑵	7
Gatam等^[10]	Retrospective	印度尼西亚Indonesia	2021	TMS	73	52.3±6.13	28/45	⑵	7
Heo等^[11]	Prospective	韩国Korea	2018	UBES	46	65.8±8.9	18/28	⑴⑵⑶⑺	7
Heo等^[11]	Prospective	韩国Korea	2018	TMS	42	63.6±10.5	16/26	⑴⑵⑶⑺	7
Hua等^[12]	Retrospective	中国China	2020	UBES	32	56.7±9.1	12/20	⑴⑵⑶⑷⑸⑹⑺⑻	8
Hua等^[12]	Retrospective	中国China	2020	TMS	80	58.8±10.5	32/48	⑴⑵⑶⑷⑸⑹⑺⑻	8
Ito等^[13]	Retrospective	日本Japan	2021	UBES	42	66.3±12.3	28/14	⑶⑺	7
Ito等^[13]	Retrospective	日本Japan	2021	TMS	139	65.0±11.1	71/68	⑶⑺	7
Kang等^[14]	Prospective	韩国Korea	2019	UBES	32	65.1±8.6	18/14	⑶⑺⑻	7
Kang等^[14]	Prospective	韩国Korea	2019	TMS	30	67.2±9.5	14/16	⑶⑺⑻	7
Kim等^[15]	Retrospective	韩国Korea	2021	UBES	32	70.5±8.26	17/15	⑴⑵⑶⑸⑹⑺⑻	7
Kim等^[15]	Retrospective	韩国Korea	2021	TMS	55	67.3±10.7	25/30	⑴⑵⑶⑸⑹⑺⑻	7
Min等^[16]	Retrospective	韩国Korea	2019	UBES	54	65.74±10.52	27/27	⑴⑵⑶⑸⑹⑺	8
Min等^[16]	Retrospective	韩国Korea	2019	TMS	35	66.74±7.96	19/16	⑴⑵⑶⑸⑹⑺	8
赵子豪等^[17]	Retrospective	中国China	2021	UBES	34	65.71±10.55	16/18	⑴⑵⑶⑸⑹	7
赵子豪等^[17]	Retrospective	中国China	2021	TMS	31	66.53±8.17	15/16	⑴⑵⑶⑸⑹	7
庹伟等^[18]	Retrospective	中国China	2021	UBES	22	59.1±11.7	12/10	⑴⑵⑷⑺	7
庹伟等^[18]	Retrospective	中国China	2021	TMS	25	58.3±8.7	11/14	⑴⑵⑷⑺	7
Choi等^[19]	Retrospective	韩国Korea	2019	UBES	35	65.4±11.8	14/21	⑴⑺	7
Choi等^[19]	Retrospective	韩国Korea	2019	TMS	30	65.2±12.0	17/13	⑴⑺	7
Heo等^[20]	Prospective	韩国Korea	2019	UBES	37	66.7±9.4	15/22	⑴⑵⑶⑺	7
Heo等^[20]	Prospective	韩国Korea	2019	TMS	33	63.4±11.1	12/21	⑴⑵⑶⑺	7
Park等^[21]	Prospective	韩国Korea	2019	UBES	32	NA	13/19	⑴⑵⑶⑹⑺	8
Park等^[21]	Prospective	韩国Korea	2019	TMS	32	NA	18/14	⑴⑵⑶⑹⑺	8

图5 UBES与TMS治疗腰椎管狭窄症术后ODI评分的Meta分析

图9 UBES与TMS治疗腰椎管狭窄症住院时间的Meta分析

图12 结局指标漏斗图（a：术后腰痛VAS评分（1周内、1周~1月、1~3月）、b：术后下肢痛VAS评分（1周内、1周~1月、1~3月）、c：术后ODI评分（1月内、1~3月）、d：手术时间、e：术中出血量、f：离床活动时间、g：住院时间、h：术后总并发症、i：术后优良率）

1	Deer T, Sayed D, Michels J, et al. A review of lumbar spinal stenosis with intermittent neurogenic claudication:disease and diagnosis [J]. Pain Med, 2019, 20(Suppl 2): S32-S44.
2	Ammendolia C, Hofkirchner C, Plener J, et al. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review [J]. BMJ Open, 202212(1): e057724. Ng KKM, Cheung JPY. Is minimally invasive surgery superior to open surgery for treatment of lumbar spinal stenosis? A systematic review [J]. J Orthop Surg (Hong Kong), 2017, 25(2): 2309499017716254.
3	Liang Z, Xu X, Chen X, et al. Clinical Evaluation of Surgery for Single-Segment Lumbar Spinal Stenosis: A Systematic Review and Bayesian Network Meta-Analysis [J]. Orthop Surg, 2022, 14(7): 1281-1293.
4	Kim CH, Easley K, Lee JS, et al. Comparison of Minimally Invasive Versus Open Transforaminal Interbody Lumbar Fusion [J]. Global Spine J, 2020, 10(2 Suppl): 143S-150S.
5	Li WS, Yan Q, Cong L. Comparison of Endoscopic Discectomy Versus Non-Endoscopic Discectomy for Symptomatic Lumbar Disc Herniation: A Systematic Review and Meta-Analysis [J]. Global Spine J, 2022, 12(5): 1012-1026.
6	朱斌,田大胜,陈磊,等.单边双通道内镜技术在腰椎疾病中的应用研究进展[J].中华骨科杂志, 2020, 40(15): 1030-1038.
7	Aygun H, Abdulshafi K. Unilateral biportal endoscopy versus tubular microendoscopy in management of single level degenerative lumbar canal stenosis: a prospective study [J]. Clin Spine Surg, 2021, 34(6): E323-E328.
8	Carrascosa-Granada A, Velazquez W, Wagner R, et al. Comparative study between uniportal Full-Endoscopic interlaminar and tubular approach in the treatment of lumbar spinal stenosis:a pilot study [J]. Global Spine J, 2020, 10(2 Suppl): 32528810.
9	Gatam AR, Gatam L, Mahadhipta H, et al. Unilateral biportal endoscopic lumbar interbody fusion:a technical Note and an outcome comparison with the conventional minimally invasive fusion [J]. Orthop Res Rev, 2021, Nov 24(13): 229-239.
10	Heo DH, Quillo-Olvera J, Park CK. Can percutaneous biportal endoscopic surgery achieve enough canal decompression for degenerative lumbar stenosis? prospective Case-Control study [J]. World Neurosurg, 2018, 120: e684-e689.
11	Hua WB, Wang BJ, Ke WC, et al. Comparison of lumbar endoscopic unilateral laminotomy bilateral decompression and minimally invasive surgery transforaminal lumbar interbody fusion for one-level lumbar spinal stenosis [J]. BMC Musculoskelet Disord, 2020, 21(1): 785.
12	Ito Z, Shibayama M, Nakamura S, et al. Clinical comparison of unilateral biportal endoscopic laminectomy versus microendoscopic laminectomy for Single-Level laminectomy: a Single-Center, retrospective analysis [J]. World Neurosurg, 2021, 148: e581-e588.
13	Kang T, Park SY, Kang CH, et al. Is biportal technique/endoscopic spinal surgery satisfactory for lumbar spinal stenosis patients?: A prospective randomized comparative study [J]. Medicine (Baltimore), 2019, 98(18): e15451.
14	Kim JE, Yoo HS, Choi DJ, et al. Comparison of minimal invasive versus biportal endoscopic transforaminal lumbar interbody fusion for single-level lumbar disease [J]. Clin Spine Surg, 2021, 34(2): E64-E71.
15	Min Woo-Kie, Kim Ju-Eun, Choi Dae-Jung, et al. Clinical and radiological outcomes between biportal endoscopic decompression and microscopic decompression in lumbar spinal stenosis [J]. J orthop Sci, 2020, 25(3): 371-378.
16	赵子豪,李雪城,李建军,等.单侧双通道内镜与经通道显微镜减压技术治疗腰椎管狭窄症疗效比较[J].滨州医学院学报, 2021, 44(05): 341-345.
17	庹伟,周霖,刘德森,等.单侧双通道内镜技术治疗腰椎管狭窄的初步研究[J].中国微创外科杂志, 2021, 21(1): 56-60.
18	Choi DJ, Kim JE. Efficacy of biportal endoscopic spine surgery for lumbar spinal stenosis [J]. Clin Orthop Surg, 2019, 11(1): 82-88.
19	Heo DH, Lee DC, Park CK. Comparative analysis of three types of minimally invasive decompressive surgery for lumbar central stenosis: biportal endoscopy, uniportal endoscopy, and microsurgery [J]. Neurosurg Focus, 2019, 46(5): E9.
20	Park SM, Park J, Jang HS, et al. Biportal endoscopic versus microscopic lumbar decompressive laminectomy in patients with spinal stenosis: a randomized controlled trial [J]. Spine J, 2020, 20(2): 156-165.
21	Diwan S, Sayed D, Deer TR, et al. An Algorithmic Approach to Treating Lumbar Spinal Stenosis: An Evidenced-Based Approach [J]. Pain Med. 2019, 20(Suppl 2): 23-S31.
22	Liu C, Liu K, Chu L, et al. Posterior percutaneous endoscopic cervical discectomy through lamina-hole approach for cervical intervertebral disc herniation [J]. Int J Neurosci, 2019, 129(7): 627-634.
23	Aihara T, Endo K, Suzuki H, et al. Long-Term outcomes following lumbar microendoscopic decompression for lumbar spinal stenosis with and without degenerative spondylolisthesis: minimum 10-Year Follow-Up [J]. World Neurosurg, 2021, 146: e1219-e1225.
24	Aihara T, Endo K, Suzuki H, et al. Long-Term Outcomes Following Lumbar Microendoscopic Decompression for Lumbar Spinal Stenosis with and without Degenerative Spondylolisthesis: Minimum 10-Year Follow-Up [J]. World Neurosurg, 2021, 146: e1219-e1225.
25	Shi R, Wang F, Hong X, et al. Comparison of percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for the treatment of lumbar disc herniation: a meta-analysis [J]. Int Orthop, 2019, 43(4): 923-937.
26	Xie XH, Zhang GQ, Liu N. Clinical effect of unilateral biportal endoscopy in the treatment of lumbar diseases: a systematic review and meta-analysis [J]. Wideochir Inne Tech Malo Inwazyjne, 2022, 17(1): 61-68.
27	Wang B, He P, Liu X, et al. Complications of unilateral biportal endoscopic spinal surgery for lumbar spinal stenosis: a systematic review of the literature and meta-analysis of single-arm studies [J]. Orthop Surg, 2023, 15(1): 3-15.
28	Chang HR, Xu JX, Yang DL, et al. Comparison of full-endoscopic foraminoplasty and lumbar discectomy (FEFLD), unilateral biportal endoscopic (UBE) discectomy, and microdiscectomy (MD) for symptomatic lumbar disc herniation [J]. Eur Spine J, 2023, 32(2): 542-554.
29	Kim HS, Choi SH, Shim DM, Lee IS, Oh YK, Woo YH. Advantages of New Endoscopic Unilateral Laminectomy for Bilateral Decompression (ULBD) over Conventional Microscopic ULBD [J]. Clin Orthop Surg, 2020, 12(3): 330-336.
30	Junjie L, Jiheng Y, Jun L, et al. Comparison of unilateral biportal endoscopy decompression and microscopic decompression effectiveness in lumbar spinal stenosis treatment: a systematic review and meta-analysis [J]. Asian Spine J, 2023, Online ahead of print.
31	Choi CM. Biportal endoscopic spine surgery(BESS):considering merits and pitfalls [J]. J Spine Surg, 2019, 6(2): 457-465.
32	Lin GX, Huang P, Kotheeranurak V, et al. A systematic review of unilateral biportal endoscopic spinal surgery: preliminary clinical results and complications [J]. World Neurosurg, 2019, 125: 425-432.
33	Kwon O, Yoo SJ, Park JY. Comparison of unilateral biportal endoscopic discectomy with other surgical technics: a systemic review of indications and outcomes of unilateral biportal endoscopic discectomy from the current literature [J]. World Neurosurg, 2022, 168: 349-358.
34	Zheng B XSCLCHE, Safety of Unilateral Biportal Endoscopy Versus Other Spine Surgery:a Systematic Review, Meta-Analysis M. Front Surg [J]. Front Surg, 2022, 25(9): 911914..
35	Pairuchvej S, Muljadi JA, Ho JC, et al. Full-endoscopic (bi-portal or uni-portal) versus microscopic lumbar decompression laminectomy in patients with spinal stenosis: systematic review and meta-analysis [J]. Eur J Orthop Surg Traumatol, 2020, 30(4): 595-611.
36	McGregor AH, Probyn K, Cro S, et al. Rehabilitation following surgery for lumbar spinal stenosis [J]. Cochrane Database Syst Rev, 2013, 9 (12): CD009644.

[1]	张思平, 刘伟, 马鹏程. 全膝关节置换术后下肢轻度内翻对线对疗效的影响[J]. 中华关节外科杂志(电子版), 2023, 17(06): 808-817.
[2]	罗旺林, 杨传军, 许国星, 俞建国, 孙伟东, 颜文娟, 冯志. 开放性楔形胫骨高位截骨术不同植入材料的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(06): 818-826.
[3]	马鹏程, 刘伟, 张思平. 股骨髋臼撞击综合征关节镜手术中闭合关节囊的疗效影响[J]. 中华关节外科杂志(电子版), 2023, 17(05): 653-662.
[4]	陈宏兴, 张立军, 张勇, 李虎, 周驰, 凡一诺. 膝骨关节炎关节镜清理术后中药外用疗效的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(05): 663-672.
[5]	邢阳, 何爱珊, 康焱, 杨子波, 孟繁钢, 邬培慧. 前交叉韧带单束联合前外侧结构重建的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(04): 508-519.
[6]	李雄雄, 周灿, 徐婷, 任予, 尚进. 初诊导管原位癌伴微浸润腋窝淋巴结转移率的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(06): 466-474.
[7]	张再博, 王冰雨, 焦志凯, 檀碧波. 胃癌术后下肢深静脉血栓危险因素的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(06): 475-480.
[8]	武慧铭, 郭仁凯, 李辉宇. 机器人辅助下经自然腔道取标本手术治疗结直肠癌安全性和有效性的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(05): 395-400.
[9]	莫闲, 杨闯. 肝硬化患者并发门静脉血栓危险因素的Meta分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 678-683.
[10]	刘佳铭, 孙晓容, 文健, 何晓丽, 任茂玲. 有氧运动对成人哮喘肺功能、生活质量以及哮喘控制影响的Meta分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 592-595.
[11]	谭海宁, 于凌佳, 谢学虎, 刘宁, 张国强, 李想, 杨雍, 祝斌. 单通道全脊柱内镜治疗腰椎管狭窄症的隐性失血及危险因素分析[J]. 中华腔镜外科杂志(电子版), 2023, 16(04): 233-238.
[12]	段文忠, 白延霞, 徐文亭, 祁虹霞, 吕志坚. 七氟烷和丙泊酚在肝切除术中麻醉效果比较Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 640-645.
[13]	杨海龙, 邓满军, 樊羿辰, 徐梦钰, 陈芳德, 吴威浩, 张生元. 腹腔镜胆总管探查术一期缝合术后胆漏危险因素Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 545-550.
[14]	阿依别克·吐尔得汉, 陈伦牮, 巴合体·卡力甫, 陈雄, 梦塬. 血清免疫抗原在包虫病诊断中的价值Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 300-304.
[15]	徐红莉, 杨钰琳, 薛清, 张茜, 马丽虹, 邱振刚. 体外冲击波治疗非特异性腰痛疗效的系统评价和Meta分析[J]. 中华老年骨科与康复电子杂志, 2023, 09(05): 307-314.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Efficacy and safety of unilateral biportal endoscopy versus tubular microendoscopic for lumbar spinal stenosis: A systematic review and meta-analysis

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Efficacy and safety of unilateral biportal endoscopy versus tubular microendoscopic for lumbar spinal stenosis: A systematic review and meta-analysis