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Three-dimensional intraoperative imaging with O-arm to establish a working trajectory in percutaneous endoscopic
Shu Wei1, Wei Tao1, Hongwei Zhu1
1Xuanwu Hospital, Capital Medical University, Beijing, China.
Introduction:
Successful percutaneous endoscopic lumbar discectomy (PELD) requires an appropriate working trajectory. Due to the complexity of spinal anatomy, this is difficult to verify with conventional 2-dimensional fluoroscopy.
Aim:
Here we assessed the feasibility and utility of the O-arm for establishing the working trajectory for PELD.
Material And Methods:
We retrospectively reviewed the records of 89 patients with lumbar disc herniation who underwent PELD using the O-arm. The working trajectory was evaluated with standard fluoroscopic images or 3-dimensional, volumetric computed tomography scan. Based on the detail provided by the multiplanar view, we confirmed the ideal working trajectory and adjusted the surgical approach accordingly.
Results:
At the 12-month follow-up, based on MacNab's criteria, 85.9% of patients showed an excellent or good outcome. There were no major complications.
Conclusions:
The O-arm provides detailed multiplanar intraoperative high-quality imaging for PELD, and enables the surgeon to ascertain the surgical anatomy, determine the optimal working trajectory, and improve the accuracy of surgery.
