Kirschner wire as an effective localization tool in UBE discectomy: enhancing segmental localization accuracy and...

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Unilateral biportal endoscopic (UBE) surgery is an advanced technique for lumbar disc herniation (LDH).
• Conventional localization methods in UBE surgery present challenges in accuracy, efficiency, and decompression extent.
• Incomplete or over-decompression during UBE surgery can lead to adverse patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of Kirschner wires as a novel localization tool in UBE discectomy.
• To compare surgical precision, operative efficiency, and patient outcomes between UBE with and without Kirschner wires.

Main Methods:

• A comparative study involving 78 patients undergoing UBE discectomy with Kirschner wires and 73 patients with standard UBE discectomy.
• Analysis of demographic data, surgical variables (localization accuracy, operation time, blood loss), postoperative complications, and health-related quality of life (HRQOL).
• Assessment of decompression extent, including incomplete decompression, over-decompression, and facet joint injury.

Main Results:

• The Kirschner wire group showed significantly fewer incorrect segmental localizations (2 vs. 11).
• UBE surgery with Kirschner wires resulted in shorter operation times, reduced fluoroscopy exposure, less blood loss, and minimized paraspinal muscle injury.
• No incomplete decompression occurred in the Kirschner wire group, compared to 4 cases requiring revision in the standard group; facet injury was also reduced.

Conclusions:

• Kirschner wires serve as an effective tool for precise segmental localization in UBE discectomy.
• This method aids in achieving appropriate decompression, reducing complications, and improving surgical efficiency.
• The use of Kirschner wires in UBE discectomy is recommended to enhance surgical precision and patient outcomes.