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Published on: July 15, 2021
Simplified Guiding-Rod Positioning Combined With Visual Trephination: A Safe, Easy, and Efficient Technique for
Baozhi Ding1, Haijun Tian2, Jie Zhao3
1Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background:
This study aimed to investigate the early clinical efficacy of using a "guiding rod" simplified positioning technique combined with percutaneous endoscopic visual trephine for the 1-stage treatment of L4/L5 and L5/S1 lumbar disc herniations (LDHs) using transforaminal and interlaminar approaches.
Methods:
A retrospective analysis was conducted using the clinical data of 22 patients with concurrent L4/L5 and L5/S1 LDHs who underwent percutaneous endoscopic transforaminal discectomy at the L4/L5 level and percutaneous endoscopic interlaminar discectomy at the L5/S1 treatment by using the "guiding rod" simplified position in combination with percutaneous endoscopic visual trephine in our hospital's orthopedic department from January 2022 to February 2024.
Results:
All procedures were completed without complications. The total number of C-arm fluoroscopies was 7.18 ± 1.30. The visual trephine was used for 3.82 ± 1.76 minutes for foraminoplasty and 7.11 ± 3.91 minutes for laminoplasty. The mean operative times were 48.72 ± 11.43 minutes for the lateral approach and 50.37 ± 12.31 minutes for the posterior approach. Postoperative visual analog scale scores for low back and leg pain, Japanese Orthopedic Association scores, and Oswestry Disability Index scores improved significantly compared with preoperative levels (P < 0.05).
Conclusions:
This technique offers a safe, minimally invasive, and efficient option for treating dual-segment LDH.
Clinical Relevance:
Advanced techniques in percutaneous endoscopic lumbar discectomy.
