Abstract:Objective To evaluate clinical application value of percutaneous endoscopic lumbar decompression (PELD) by visualization foraminoplasty with off-center rod.Methods The clinical data of 30 patients from the Third Hospital of Hebei Medical University with lumbar degenerative disease who underwent transforaminal endoscopic spine system (TESSYS group,15) and visualization foraminoplasty with off-centered rod (I see group,15) separately were retrospectively reviewed and selected, including 15 males and 15 females with an age of 39-61(48.57±5.91) years. Among them, the lesion spine level was located at L4-5 segment in 17 patients and L5-S1 in 13 patients. The catheter placement time, intraoperative radiation exposure time, decompression time, and superior articular process removal rate were compared between the two groups. visual analog scale(VAS), Oswestry disability index(ODI) and Japanese Orthopedics Association(JOA) scores of waist and leg were compared before and immediately after surgery and 3, 6 and 12 months after surgery. MacNab was used to evaluate the efficacy 12 months after the operation.Results The operation was performed successfully for all patients. The catheter placement time and intraoperative radiation exposure time in the I see group were (16.73±2.46) min and (38.15±5.72) s, respectively, which were significantly lower than those in TESSYS group [(19.87±3.79) min and (49.79±7.40) s, respectively]. The percentage of superior articular process resection in the I see group was 32.25%±1.12%, which was higher than that in the TESSYS group (12.02%±0.67%). The differences were statistically significant (t=2.682, 4.820, 38.890, all P values<0.05). There was no significant difference in intraoperative decompression time between the two groups (P>0.05). In the two groups, VAS and ODI of lumbar and leg pain at different postoperative time were significantly decreased, and JOA score was significantly increased compared with that before surgery, with statistically significant differences (FI see group=167.298, 268.815, 7271.864, 316.342, FTESSYS group=168.759, 341.300, 1368.354, 141.090, all P values<0.05).Compared the I see group with the TESSYS group, VAS, ODI and JOA scores of lumbago and leg pain at different postoperative time were not statistically significant(all P values>0.05). Twelve months after the operation, MacNab evaluation criteria were used to evaluate the efficacy. There were 8 excellent cases, 4 good cases and 3 acceptable cases in the I see group, and 7 excellent cases, 6 good cases and 6 acceptable cases in the TESSY group. The difference between the two groups was not statistically significant (Z=0.114, P>0.05).Conclusions For lumbar disc herniation, off-center rod with ISEE is a safe and effective foraminoplasty. It can reduce intraoperative radiation frequency, minimize the intraoperative radiation exposure and increase the superior articular process resection rate.
王宪正, 李佳奇, 孙亚彭, 张飞, 李泽阳, 崔浩, 高原, 张为. 偏心导杆结合可视化椎间孔成形技术在腰椎间盘切除术中的临床应用[J]. 中华解剖与临床杂志, 2019, 24(5): 464-469.
Wang Xianzheng, Li Jiaqi, Sun Yapeng, Zhang Fei, Li Zeyang, Cui Hao, Gao Yuan, Zhang Wei. Clinical application of visualization foraminoplasty with off-center rod. Chinese Journal of Anatomy and Clinics, 2019, 24(5): 464-469.
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