Development and clinical application of the puncture guidance instrument for percutaneous transforaminal endoscopic discectomy

doi:10.3969/j.issn.2095-4344.0610

Abstract

Abstract:

BACKGROUND: Percutaneous transforaminal endoscopic discectomy is currently the most minimally invasive treatment of lumbar disc herniation. It is essential to operation success that the puncture needle can accurately reach the target. But percutaneous transforaminal endoscopic discectomy has steep learning curve. Free hand can easily result in inadequate puncture.

OBJECTIVE: To evaluate the puncture accuracy and safety of percutaneous puncture guidance instrument for percutaneous transforaminal endoscopic discectomy.

METHODS: The design principle of puncture guidance instrument for percutaneous transforaminal endoscopic discectomy was right triangle. From January 2014 to July 2016, 60 patients with lumber disc herniation were randomly divided into navigation group (n=33, percutaneous transforaminal endoscopic discectomy with a novel puncture guidance instrument) and free hand group (n=27, percutaneous transforaminal endoscopic discectomy with a free hand method).The times for puncture, puncture time, times for fluoroscopy, Japanese Orthopaedic Association score and Oswestry Disability Index at 1 year postoperatively were recorded and compared between two groups.

RESULTS AND CONCLUSION: (1) All patients underwent the operation successfully. (2) The average puncture times, the average fluoroscopic exposure time and the preoperative location and puncture-channel time in the navigation group were significantly less than those in the free hand group (P < 0.05). (3) Japanese Orthopaedic Association scores and Oswestry Disability Index at 1 year postoperatively in both groups were significantly improved compared with the baseline (P < 0.05). The scores showed no significant differences between two groups (P > 0.05). (4) Our results indicate that the puncture guidance instrument for percutaneous transforaminal endoscopic discectomy can improve the puncture accuracy, especially for a beginner.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Lumbar Vertebrae, Intervertebral Disk Displacement, Spinal Puncture, Radiation Injuries, Tissue Engineering

CLC Number:

R459.9

Li Ming, Zhong Yanxue, Zhu Zhongjiao, Li Yong, Sun Jinbao, Zhang Guodong. Development and clinical application of the puncture guidance instrument for percutaneous transforaminal endoscopic discectomy[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(35): 5625-5630.

Figures/Tables 4

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