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Computed Tomography-Guided Endoscopic Surgery in Lumbar Disc Herniation With High-grade Migration: A Retrospective,
Erh-Ti Lin1, Pang-Hsuan Hsiao2, Chia-Yu Lin1
1Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan (ROC).
Pain Physician
|July 28, 2022
Summary
Computed tomography (CT)-navigated percutaneous endoscopic lumbar discectomy offers enhanced early functional recovery for herniated discs with high-grade migration. This advanced technique proves safe and effective compared to conventional fluoroscopic guidance.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Minimally Invasive Surgery
Background:
- Symptomatic herniated intervertebral discs can be debilitating.
- Surgical management of high-grade migrated lesions presents challenges for endoscopic spine surgeons.
Purpose of the Study:
- To assess surgical and clinical outcomes of CT-navigated percutaneous endoscopic lumbar discectomy.
- To compare outcomes between CT-navigation (O-arm) and conventional fluoroscopic guidance (C-arm).
Main Methods:
- Retrospective analysis of 21 patients with high-grade lumbar disc migration undergoing percutaneous endoscopic lumbar discectomy.
- Patients divided into two groups: CT-navigation (O-arm) and conventional fluoroscopic guidance (C-arm).
- Intraoperative 3D imaging with O-arm enabled multiplanar visualization; C-arm used conventional imaging.
Main Results:
- Operative time, blood loss, and hospital stay were similar between groups.
- CT-navigation group showed greater pain reduction and faster functional recovery post-surgery and at one-year follow-up (significant for Oswestry Disability Index).
Conclusions:
- CT-navigated percutaneous endoscopic surgery is safe and effective for lumbar disc herniation with high-grade migration.
- CT-navigation enhances early functional recovery compared to conventional fluoroscopic guidance.
