Simplified Guiding-Rod Positioning Combined With Visual Trephination: A Safe, Easy, and Efficient Technique for...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar disc herniations (LDHs) at L4/L5 and L5/S1 levels often require effective treatment strategies.
• Percutaneous endoscopic discectomy is a minimally invasive option for LDH treatment.

Purpose of the Study:

• To evaluate the early clinical efficacy of a simplified guiding rod positioning technique combined with percutaneous endoscopic visual trephine.
• To assess this technique for the one-stage treatment of concurrent L4/L5 and L5/S1 lumbar disc herniations.

Main Methods:

• Retrospective analysis of 22 patients with concurrent L4/L5 and L5/S1 LDHs.
• Treatment involved percutaneous endoscopic transforaminal discectomy (L4/L5) and interlaminar discectomy (L5/S1) using the guiding rod technique and visual trephine.
• Data collected from January 2022 to February 2024.

Main Results:

• All procedures were completed without complications.
• Significant improvements observed in postoperative visual analog scale (VAS) scores for low back and leg pain, Japanese Orthopedic Association (JOA) scores, and Oswestry Disability Index (ODI) scores compared to preoperative levels (P < 0.05).
• Mean operative times were comparable for lateral and posterior approaches.

Conclusions:

• The guiding rod simplified positioning technique combined with percutaneous endoscopic visual trephine is a safe, minimally invasive, and efficient option for treating dual-segment LDH.
• This advanced technique represents a valuable addition to percutaneous endoscopic lumbar discectomy procedures.