Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis

XU Guan-peng; LIU Ting-yu; LIU Jun; REN Wei-jian

doi:10.11659/jjssx.11E025120

您当前的位置：

首页 >

文章列表页 >

Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis

Minimally Invasive Orthopedic Techniques and Perioperative Safety | 更新时间：2026-07-24

- Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 7, Pages: 569-573(2026)
- 作者机构：
  
  1.辽宁省人民医院骨五科，辽宁沈阳 110016
  2.四川大学华西临床医学院康复医学科，四川成都 610041
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E025120
  CLC： R681.5
- Received：05 November 2025，
  
  Online First：24 July 2026，
  
  Published：25 July 2026
- 稿件说明：
移动端阅览
徐贯彭,刘莛予,刘军等.单侧双通道内镜腰椎融合术治疗单节段Ⅰ度腰椎滑脱症失血量的危险因素分析[J].局解手术学杂志,2026,35(07):569-573.

XU Guan-peng,LIU Ting-yu,LIU Jun,et al.Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):569-573.
徐贯彭,刘莛予,刘军等.单侧双通道内镜腰椎融合术治疗单节段Ⅰ度腰椎滑脱症失血量的危险因素分析[J].局解手术学杂志,2026,35(07):569-573. DOI： 10.11659/jjssx.11E025120.

XU Guan-peng,LIU Ting-yu,LIU Jun,et al.Risk factors for blood loss in unilateral biportal endoscopic lumbar interbody fusion for single-segment grade Ⅰ lumbar spondylolisthesis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(07):569-573. DOI： 10.11659/jjssx.11E025120.

摘要

目的

探讨单侧双通道内镜腰椎融合术（UBE-LIF）治疗单节段Ⅰ度腰椎滑脱症患者的失血情况，并分析影响失血量的相关危险因素。

方法

回顾性分析2023年4月至2024年10月辽宁省人民医院收治的52例单节段Ⅰ度腰椎滑脱症患者的临床资料。收集患者的一般资料[年龄、性别、体质量指数（BMI）、高血压及糖尿病等

]

、手术资料（病变节段、手术时间）以及相关检验指标[骨密度、血红蛋白（Hb）、红细胞压积（HCT）、血小板计数（PLT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）

]

。应用Gross公式计算总失血量。进行单因素分析和

Pearson

相关性分析初步筛选与失血量相关的因素，应用多因素线性回归模型确定失血量的独立危险因素，并构建受试者工作特征（

ROC

）曲线评估各危险因素对失血量的预测效能。

结果

患者平均手术时间为（270.58±59.61）min，总失血量为（308.15±121.36）mL。术后Hb为（113.63±12.23）g/L，低于术前的（127.48±12.08）g/L（

0.05）；术后HCT为（34.42±4.41）%，低于术前的（38.61±4.91）%（

0.05）。单因素分析显示，性别、高血压、糖尿病和病变节段与失血量无显著相关性（

0.05）。

Pearson

Abstract

Objective

To investigate blood loss in patients with single-segment grade Ⅰ lumbar spondylolisthesis treated with unilateral biportal endoscopic lumbar interbody fusion （UBE-LIF） and to analyze the risk factors associated with blood loss.

Methods

A retrospective analysis was conducted on the clinical data of 52 patients with single-segment grade Ⅰ lumbar spondylolisthesis admitted to People's Hospital of Liaoning Province from April 2023 to October 2024. The general information ［age，gender，body mass index （BMI）］，hypertension and diabetes），surgical details （involved segment，operative time），and related laboratory indicators ［bone mineral density，hemoglobin （Hb），hematocrit （HCT），platelet count （PLT），prothrombin time （PT），activated partial thromboplastin time （APTT），and fibrinogen （FIB）］. Total blood loss was calculated using the Gross formula. Univariate analysis and

Pearson

correlation analysis were conducted to preliminarily screen factors related to blood loss. Multiple linear regression model was performed to identify independent risk factors for blood loss，and

receiver operating characteristic

（

ROC

） curve was constructed to evaluate the predictive performance of each risk fa

ctor for blood loss.

Results

The mean operative time was （270.58±59.61）minutes，and the total blood loss was （308.15±121.36）mL. Postoperative Hb was （113.63±12.23）g/L，which was lower than the preoperative value of （127.48±12.08）g/L （

0.05）. Postoperative HCT was （34.42±4.41）%，which was lower than the preoperative value of （38.61±4.91）% （

0.05）. Univariate analysis showed that no significant correlations were found between blood loss and gender，hypertension，diabetes，or affected segment （

0.05）.

Pearson

correlation analysis revealed that operative time （

=0.562，

=0.032），bone mineral density （

=-0.412，

=0.021），PLT （

=-0.421，

=0.018），and APTT （

=-0.392，

=0.029） were significantly correlated with blood loss，while age （

=0.306，

=0.095），BMI （

=0.274，

=0.136），PT （

=-0.014，

=0.983），and FIB （

=0.184，

=0.323） showed no significant correlations with blood loss.

ROC

curve analysis showed that the

area under the curve

（

AUC

） for predicting severe blood loss was 0.813 （95%

： 0.688 to 0.938，

0.001） for operative time，0.794 （95%

： 0.654 to 0.934，

0.001） for bone mineral density，and 0.802（95%

：0.683 to 0.921，

0.001） for PLT，indicating good predictive value for severe blood loss. Multiple linear regression analysis showed that prolonged operative time，and decreased bone mineral density and PLT were independent risk factors for blood loss （

0.05）.

Conclusion

UBE-LIF for single‑segment grade Ⅰ lumbar spondylolisthesis results in a certain degree of blood loss. The prolonged operative time，decreased bone mineral density and reduced PLT are independent risk factors for increased postoperative blood loss. In clinical practice，more intensive management should be considered for patients presenting with these features to enhance surgical safety.

关键词

Keywords

references

Sakhrekar R ， Ha JS ， Han HD ， et al . The past，present，and future of unilateral biportal endoscopy with a technical note on novel endoscopic visualization pedicle screw insertion technique and UBE-transforaminal lumbar interbody fusion technique with literature review ［J］. J Orthop Case Rep ， 2023 ， 13 （ 12 ）： 165 - 171 . doi： 10.13107/jocr.2023.v13.i12.4120 http://dx.doi.org/10.13107/jocr.2023.v13.i12.4120 .

Chu PL ， Wang T ， Zheng JL ， et al . Global and current research trends of unilateral biportal endoscopy/biportal endoscopic spinal surgery in the treatment of lumbar degenerative diseases： a bibliometric and visuali-zation study ［J］. Orthop Surg ， 2022 ， 14 （ 4 ）： 635 - 643 . doi： 10.1111/os.13216 http://dx.doi.org/10.1111/os.13216 .

舒鹏，王智伟，陈刚，等 . 单侧双通道脊柱内镜下经椎间孔腰椎椎体间融合术治疗单节段Ⅰ、Ⅱ度腰椎滑脱症近期疗效分析［J］. 中国修复重建外科杂志， 2022 ， 36 （ 10 ）： 1207 - 1212 . doi： 10.7507/1002-1892.202205126 http://dx.doi.org/10.7507/1002-1892.202205126 .

吴帝求，舒涛，卢黔威，等 . 单侧双通道脊柱内镜与单通道脊柱内镜下经椎间孔腰椎椎间融合术治疗单节段退行性腰椎管狭窄症伴腰椎滑脱的前瞻性对比研究［J］. 中国修复重建外科杂志， 2024 ， 38 （ 5 ）： 521 - 528 . doi： 10.7507/1002-1892.202402058 http://dx.doi.org/10.7507/1002-1892.202402058 .

Bahir AW ， Daxing W ， Jiayu X ， et al . Comparative efficacy and fusion outcomes of unilateral bi-portal endoscopic transforaminal lumbar interbody fusion versus minimally invasive transforaminal lumbar interbody fusion in treating single-segment degenerative lumbar spondylolisthesis with lumbar spinal stenosis： a two-year retrospective study ［J］. J Orthop Surg Res ， 2024 ， 19 （ 1 ）： 835 - 844 . doi： 10.1186/s13018-024-05315-5 http://dx.doi.org/10.1186/s13018-024-05315-5 .

Gross JB . Estimating allowable blood loss： corrected for dilution ［J］. Anesthesiology ， 1983 ， 58 （ 3 ）： 277 - 280 . doi： 10.1097/00000542-198303000-00016 http://dx.doi.org/10.1097/00000542-198303000-00016 .

Nadler SB ， Hidalgo JH ， Bloch T ， et al . Prediction of blood volume in normal human adults ［J］. Surgery ， 1962 ， 51 （ 2 ）： 224 - 232 .

Briggs H ， Milligan PR . Chip fusion of the low back following exploration of the spinal canal ［J］. J Bone Joint Surg Am ， 1944 ， 26 ： 125 - 130 .

de Kunder SL ， van Kuijk SMJ ， Rijkers K ， et al . Transforaminal lumbar interbody fusion （TLIF） versus posterior lumbar interbody fusion （PLIF） in lumbar spondylolisthesis： a systematic review and meta-analysis ［J］. Spine J ， 2017 ， 17 （ 11 ）： 1712 - 1721 . doi： 10.1016/j.spinee.2017.06.018 http://dx.doi.org/10.1016/j.spinee.2017.06.018 .

Imada A ， Huynh TR ， Drazin D ， et al . Minimally invasive versus open laminectomy/discectomy，transforaminal lumbar，and posterior lumbar interbody fusions： a systematic review ［J］. Cureus ， 2017 ， 9 （ 7 ）： 1488 - 1496 . doi： 10.7759/cureus.1488 http://dx.doi.org/10.7759/cureus.1488 .

Koreckij TD ， Fischgrund JS . Degenerative spondylolisthesis ［J］. J Spinal Disord Tech ， 2015 ， 28 （ 7 ）： 236 - 241 . doi： 10.1097/bsd.0000000000000298 http://dx.doi.org/10.1097/bsd.0000000000000298 .

Ding Y ， Chen H ， Wu G ， et al . Comparison of efficacy and safety between unilateral biportal endoscopic transforaminal lumbar interbody fusion versus uniportal endoscopic transforaminal lumbar interbody fusion for the treatment of lumbar degenerative diseases： a systematic review and meta-analysis ［J］. BMC Musculoskelet Disord ， 2024 ， 25 （ 1 ）： 1037 . doi： 10.1186/s12891-024-08146-x http://dx.doi.org/10.1186/s12891-024-08146-x .

Lin S ， Liu S ， Li Y ， et al . Hidden blood loss of minimally invasive transforaminal lumbar interbody fusion of lumbar degenerative diseases in patients with osteoporosis： a retrospective study ［J］. J Orthop Surg Res ， 2024 ， 19 （ 1 ）： 798 - 805 . doi： 10.1186/s13018-024-05297-4 http://dx.doi.org/10.1186/s13018-024-05297-4 .

Alimohammadi E ， Sadeghsalehi A ， Ranjbari F ， et al . Low mean platelet volume： a risk factor for increased intraoperative blood loss in degenerative lumbar surgery ［J］. Neurol Res ， 2026 ， 48 （ 6 ）： 699 - 707 . doi： 10.1080/01616412.2025.2541292 http://dx.doi.org/10.1080/01616412.2025.2541292 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Risk factors for hidden blood loss after percutaneous endoscopic unilateral laminotomy for bilateral decompression in elderly patients with lumbar spinal stenosis

Construction of a risk prediction model for pressure injuries after coronary artery bypass grafting based on DynNom dynamic score

Influencing factors and risk prediction model of adverse clinical outcomes after heart valve replacement

Establishment and validation of a predictive model for increased drainage volume after open transforaminal lumbar interbody fusion

Influencing factors of liver regeneration after laparoscopic anatomic liver resection and its relationship with prognosis

Related Author

MA Xiao-liang

ZHANG Ling-hao

ZHANG Hong-tao

ZHANG Hai-gang

LI Zhan-qi

ZHANG Wei-liang

ZHU Xin-yue

XU Tian-ning

Related Institution

Department of Spine Surgery， Xi'an People's Hospital/Xi'an Fourth Hospital

Department of Orthopedics， Second Affiliated Hospital of Air Force Medical University

First Department of Blood Collection，Shaanxi Provincial Blood Center

Department of Pain Medicine，Xi'an People's Hospital/Xi'an Fourth Hospital

Cardiovascular Surgery Intensive Care Unit， the First Affiliated Hospital of Nanjing Medical University

⁰