Affiliation:
1. Fuyang District First People's Hospital
2. Xiaoshan Hospital Affiliated to Wenzhou Medical University
3. Zhejiang Chinese Medical University
4. Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College)
Abstract
Abstract
Objective: To explore the applicability of bone reamer and trephine for foraminoscopy in percutaneous endoscopic lumbar discectomy(PELD), and to provide a theoretical basis for foraminoplasty options in clinical practice.
Methods:This study was a prospective cohort study. Sixty-three consecutive patients who underwentPELD for lumbar disc herniation between May 2021 and July 2022 were analysed. Foraminoplasty were performed by bone reamer or trephine. The amount of bone resected and the area enlarged during foraminoplasty by both tools were measured by 3D slicer as well as Digimizer software, and the numbers of fluoroscopic views were recorded.
Results: The bone reamer resected less bone in the Superior Articular Process (SAP) than the trephine (t=17.507, P<0.001),and the area enlarged by the bone reamer was smaller than that of the trephine (t=10.042, P=0.002). The overall numbers of fluoroscopic views were significantly more in the bone reamer group than in the trephine group (t=19.003, P<0.001). In the bone reamer group, when the area of preoperative foraminoplasty zone was no less than 54.55 mm², the mean number of fluoroscopic views significantly decreased.(t=14.443,P=0.001).
Conclusion:Bone reamer was safer and trephine was more efficient for foraminoscopy in PELD. An area of preoperative foraminoplasty zone of 54.55 mm²can be used as a critical value: bone reamer reduced the risk for cases above the value, while trephine improved the efficiency for cases less than the value.
Publisher
Research Square Platform LLC
Reference22 articles.
1. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases;Hoogland T;Spine,2006
2. Necessity of routinely performing foraminoplasty during percutaneous endoscopic transforaminal discectomy (PETD) for lumbar disc herniation;Zhao Y;British journal of neurosurgery
3. Foraminoplasty at the Base of the Superior Articular Process with Bone Drilling for Far-Downward Discs in Percutaneous Endoscopic Lumbar Discectomy: A Retrospective Study;Yang F;Journal of pain research,2021
4. Unsuccessful percutaneous endoscopic lumbar discectomy: a single-center experience of 10,228 cases;Choi KC;Neurosurgery,2015
5. Percutaneous Full-Endoscopic Lumbar Foraminoplasty and Decompression by Using a Visualization Reamer for Lumbar Lateral Recess and Foraminal Stenosis in Elderly Patients;Lin YP;World neurosurgery,2020