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Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation Using an Endoscopic Staining: A Technical Note
Jingjing Tang1, Ziyang Liang2, Jiahui He2
1Department of Spine Surgery, the 1st Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Orthopaedic Surgery
|May 4, 2021
Summary
Percutaneous endoscopic lumbar discectomy (PELD) for herniated discs can be improved with visible endoscopic staining. This new technique precisely identifies the rupture site, reducing operation time and iatrogenic injury during PELD surgery.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Procedures
Background:
- Symptomatic lumbar disc herniation (LDH) is commonly treated with percutaneous endoscopic lumbar discectomy (PELD).
- Current PELD techniques involve prolonged exploration to locate the annulus fibrosus rupture site, leading to extended operation times and potential iatrogenic injury to healthy disc tissue.
- Aggravation of disc degeneration and early postoperative recurrence are risks associated with current PELD exploration methods.
Purpose of the Study:
- To introduce a novel, fully visible endoscopic disc staining technique using methylene blue injection during PELD.
- To address the limitations of traditional disc staining methods in PELD, such as inaccurate dosing, increased fluoroscopy, and inability to visualize the staining process.
- To improve the precision of decompression and reduce operative invasiveness in PELD for LDH.
Main Methods:
- Development and implementation of a new technique for fully visible disc staining under spinal endoscopy during PELD.
- Utilizing methylene blue injection for precise identification of the annulus fibrosus rupture site.
- Focus on real-time visualization of the staining process during the procedure.
Main Results:
- The proposed endoscopic staining technique allows for precise identification of the rupture site.
- This method aims to reduce the time required for exploration and minimize damage to undegenerated annulus fibrosus.
- Potential to decrease operative time and fluoroscopy exposure compared to traditional methods.
Conclusions:
- Visible endoscopic staining with methylene blue injection represents an advancement in PELD for LDH.
- This technique offers a more precise and less invasive approach to decompression during PELD surgery.
- Further research and clinical application are needed to validate the benefits of this novel endoscopic staining technique.
