Coaxial radiography guided puncture technique for percutaneous transforaminal endoscopic lumbar discectomy:A randomized control trial  

作　　者：Li-Ping Chen Bin-Song Wen Heng Xu Zheng Lu Lai-Jun Yan Han Deng Hong-Bo Fu Hong-Jie Yuan Pei-Pei Hu 

机构地区：[1]Department of Pain Management,The Affiliated Hospital of Xuzhou Medical College,Xuzhou 221000,Jiangsu Province,China [2]Department of Pain Management,Nantong Hospital of Traditional Chinese Medicine,Nantong 226000,Jiangsu Province,China [3]Department of Neurosurgery,Haian People's Hospital,Nantong 226001,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2023年第16期3802-3812,共11页世界临床病例杂志

摘　　要：BACKGROUND The coaxial radiography-guided puncture technique(CR-PT)is a novel technique for endoscopic lumbar discectomy.As the X-ray beam and the puncturing needle are maintained in a parallel and coaxial direction,the X-ray beam can be used to guide the trajectory angle,facilitating the choice of the puncture site and providing real-time guidance.This puncture technique offers numerous advantages over the conventional anterior-posterior and lateral radiography-guided puncture technique(AP-PT),especially in cases of herniated lumbar discs with a hypertrophied transverse process or articular process,high iliac crest,and narrowed intervertebral foramen.AIM To confirm whether CR-PT is a superior approach to percutaneous transforaminal endoscopic lumbar discectomy compared to AP-PT.METHODS In this parallel,controlled,randomized clinical trial,herniated lumbar disc patients appointed to receive percutaneous endoscopic lumbar discectomy treatment were recruited from the Pain Management Department of the Affiliated Hospital of Xuzhou Medical University and Nantong Hospital of Traditional Chinese Medicine.Sixty-five participants were enrolled and divided into either a CR-PT group or an AP-PT group.The CR-PT group underwent CR-PT,and the AP-PT group underwent AP-PT.The number of fluoroscopies during puncturing,puncture duration(min),surgery duration(min),VAS score during puncturing,and puncture success rate were recorded.RESULTS Sixty-five participants were included,with 31 participants in the CR-PT group and 34 in the AP-PT group.One participant in the AP-PT group dropped out due to unsuccessful puncturing.The number of fluoroscopies[median(P25,P75)]was 12(11,14)in the CR-PT group vs 16(12,23)in the AP-PT group,while the puncture duration(mean±SD)was 20.42±5.78 vs 25.06±5.46,respectively.The VAS score was 3(2,4)in the CR-PT group vs 3(3,4)in the AP-PT group.Further subgroup analysis was performed,considering only the participants with L5/S1 segment herniation:9 patients underwent CR-PT,and 9 underwent AP-PT.The numbe

关 键 词：Herniated lumbar disc COAXIAL PUNCTURE ANTERIOR-POSTERIOR L5/S1 

分 类 号：R687.3[医药卫生—骨科学]