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
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.
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.