The design and clinical implication of trajectory-assisting puncture device in transforaminal percutaneous full-endoscopic lumbar discectomy

English Keywords:Transforaminal percutaneous endoscopic lumbar discectomy  Trajectory-assisting puncture device  Puncture accuracy  Fluoroscopy reduction

English Abstract:

  【Abstract】 Objectives: To discuss the design principle and operation method of trajectory-assisting puncture device and its impact on puncture accuracy and fluoroscopic exposure as well as operation time of transforaminal percutaneous endoscopic lumbar discectomy(PELD). Methods: The design principle of trajectory-assisting puncture device was to keep the target point always in the center of a guided arc. 54 patients undergoing PELD were included in this retrospective study, 23 males and 31 females. Patients undergoing PELD were divided into two groups. Those receiving the self-made puncture-assisting puncture device were regarded as group A, and those undergoing conventional method was considered as group B. Puncture times, fluoroscopic exposure and operation time were recorded and compared. Results: The average puncture times was 1.22±0.57 in group A and 5.89±1.91 in group B(P<0.001). The average fluoroscopic exposure time was 14.15±2.63 in group A and 21.96±4.06 in group B(P<0.001). The average operation time was 81.37±10.62min in group A and 90.41±14.37min in group B(P=0.011). There were no significant complications in group A and B, only 1 case with intervertebral disc residue postoperatively was found in group A. There was no significant difference in complication rate between the two groups(P=0.313). Conclusions: Trajectory-assisting puncture device can significantly improve the puncture accuracy of PELD and reduce its fluoroscopy exposure as well as operation time, which indicates its great potential in the future clinical applications.