The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Visual trephine for foraminoplasty in percutaneous endoscopic transforaminal discectomy

Author : LI Jie1, 3, DIAO Wenbo2, LI Yi-ming1, SUN Zhong-yi3 , LIN Hao3, WANG Hai-bin3, TIAN Ji-wei3.     
Working unit : 1.Department of Orthopedics, Xuzhou Central Hospital, Xuzhou 221009, China; 2.Department of Orthopaedics, Zhoukou Union Osteological Hospital, Zhoukou 466000, China; 3 .Department of Orthopedics, The Affiliated Nanjing Jiangbei People's Hospital, Nantong University, Nanjing 210048, China
Page : 2242-2246.
Key words : lumbar disc herniation (LDH) , percutaneous endoscopic transforaminal discectomy (PETD) , foraminoplasty, visual trephine
Abstract: [Objective] To explore the effectiveness and the safety of visual trephine for foraminoplasty in percutaneous endoscopic transforaminal discectomy (PETD) . [Methods] A retrospective study was conducted on 61 patients who underwent PETD for single segmental lumbar disc herniation (LDH) in our department from January 2016 to June 2018. Of them, 31 patients had foraminoplasty conducted by visual trephine (the visual group) , while the remaining 30 patients received foraminoplasty with trephine under the guidance of the C- arm fluoroscopy (the fluoroscopy group) . The perioperative data, including time for creating work channel and fluoroscopic frequency, clinical and radiographic consequences were compared between the two groups. [Results] The patients in both groups had operation conduced smoothly. Except temporary sensory disturbance happened in 2 patient of the fluoroscopy group due to outlet nerve injury, no serious complications occurred in anyone of both groups. The visual group consumed significantly shorter time to create the work channel [(34.13±5.32) min vs (44.43±6.14) min,P<0.05] , associated with significantly less fluoroscopy frequency than the fluoroscopy group [(3.23±0.81) times vs (9.80± 1.19) times, P<0.05] . The follow up period lasted for more than 1 year, and no reoccurrence of LDH happened in any patient of the both groups. The VAS, ODI and JOA scores significantly improved over time in both group (P<0.05) , nevertheless no significant difference in any aforesaid parameter between the two group was proved at any matching time point (P>0.05) . Based on the MacNab's criteria, there was no significant difference in excellent and good rate of the clinical consequences between the two groups at 12 months postoperatively (87.10% vs 86.67% , P>0.05) . Regarding radiographic assessment, thehorizontal displacement and angular displacement of involved segments remained unchanged after operation compared those before operation (P>0.05) , and no a significant difference in these parameters was proved at any matching time point between the two groups (P>0.05) . [Conclusion] The visual trephine used in foraminoplasty considerably enhance the efficiency of PETD for the treatment of single segmental LDH.
summary:
Visual trephine for foraminoplasty in percutaneous endoscopic transforaminal discectomy   
LI Jie1, 3, DIAO Wenbo2, LI Yi-ming1, SUN Zhong-yi3 , LIN Hao3, WANG Hai-bin3, TIAN Ji-wei3.
Orthop J Chin, 27(24):   2242-2246.