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Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience

OBJECTIVE: To investigate the feasibility and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) with three‐step maneuver for puncture (TSMP) for lumbar herniated disc (LDH). METHODS: We performed a retrospective review of 30 patients who underwent PTED using TSMP for LDH and met i...

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Detalles Bibliográficos
Autores principales: Wang, Rui, Liang, Ze Yan, Chen, Xin Yao, Chen, Chun Mei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755869/
https://www.ncbi.nlm.nih.gov/pubmed/34873865
http://dx.doi.org/10.1111/os.13113
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author Wang, Rui
Liang, Ze Yan
Chen, Xin Yao
Chen, Chun Mei
author_facet Wang, Rui
Liang, Ze Yan
Chen, Xin Yao
Chen, Chun Mei
author_sort Wang, Rui
collection PubMed
description OBJECTIVE: To investigate the feasibility and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) with three‐step maneuver for puncture (TSMP) for lumbar herniated disc (LDH). METHODS: We performed a retrospective review of 30 patients who underwent PTED using TSMP for LDH and met inclusion criteria from January 2018 to September 2018. The primary outcome, leg or back pain, was assessed using Visual Analogue Scale (VAS). Patient surgical satisfaction was measured at 12 months post surgery using a five‐point Likert scale. Potential prognostic factors measured were demographic characteristics, duration of symptom (DOS), and involved levels. Statistical analysis was performed using Fisher exact test and t‐test. TSMP is a three‐step maneuver that builds on the concept of needle puncture site and trajectory determination based on the principles of Kambin's triangle. First, accurate direction of the puncture is confirmed by inserting the needle horizontally. Then by gradually raising the needle tail in the manner described, the superior articular facet and the intervertebral foramen are sequentially located. Finally, the needle tip slides into the intervertebral foramen to reach the target superior articular facet. RESULTS: Preoperative mean VAS was 7.6 ± 1.19, which decreased to 1.4 ± 0.97 at 12 months following treatment (P < 0.0001). Rates of surgical satisfaction per Likert scale were as follows: very satisfied and satisfied in 26 patients (86.7%). Three recurrent disc herniations of adjacent segmental levels were observed in the L5‐S1 group at eight and 12 months after surgery. VAS scores at 12 months varied significantly between L4‐L5 level surgery and L5‐S1 level surgery groups (P < 0.01). CONCLUSION: TSMP is a reliable technique for puncture into the intervertebral foramen.
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spelling pubmed-87558692022-01-19 Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience Wang, Rui Liang, Ze Yan Chen, Xin Yao Chen, Chun Mei Orthop Surg Clinical Articles OBJECTIVE: To investigate the feasibility and efficacy of percutaneous transforaminal endoscopic discectomy (PTED) with three‐step maneuver for puncture (TSMP) for lumbar herniated disc (LDH). METHODS: We performed a retrospective review of 30 patients who underwent PTED using TSMP for LDH and met inclusion criteria from January 2018 to September 2018. The primary outcome, leg or back pain, was assessed using Visual Analogue Scale (VAS). Patient surgical satisfaction was measured at 12 months post surgery using a five‐point Likert scale. Potential prognostic factors measured were demographic characteristics, duration of symptom (DOS), and involved levels. Statistical analysis was performed using Fisher exact test and t‐test. TSMP is a three‐step maneuver that builds on the concept of needle puncture site and trajectory determination based on the principles of Kambin's triangle. First, accurate direction of the puncture is confirmed by inserting the needle horizontally. Then by gradually raising the needle tail in the manner described, the superior articular facet and the intervertebral foramen are sequentially located. Finally, the needle tip slides into the intervertebral foramen to reach the target superior articular facet. RESULTS: Preoperative mean VAS was 7.6 ± 1.19, which decreased to 1.4 ± 0.97 at 12 months following treatment (P < 0.0001). Rates of surgical satisfaction per Likert scale were as follows: very satisfied and satisfied in 26 patients (86.7%). Three recurrent disc herniations of adjacent segmental levels were observed in the L5‐S1 group at eight and 12 months after surgery. VAS scores at 12 months varied significantly between L4‐L5 level surgery and L5‐S1 level surgery groups (P < 0.01). CONCLUSION: TSMP is a reliable technique for puncture into the intervertebral foramen. John Wiley & Sons Australia, Ltd 2021-12-07 /pmc/articles/PMC8755869/ /pubmed/34873865 http://dx.doi.org/10.1111/os.13113 Text en © 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Articles
Wang, Rui
Liang, Ze Yan
Chen, Xin Yao
Chen, Chun Mei
Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title_full Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title_fullStr Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title_full_unstemmed Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title_short Technical Tips for Percutaneous Transforaminal Endoscopic Discectomy: A Three‐step Maneuver for Puncture and Early Clinical Experience
title_sort technical tips for percutaneous transforaminal endoscopic discectomy: a three‐step maneuver for puncture and early clinical experience
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755869/
https://www.ncbi.nlm.nih.gov/pubmed/34873865
http://dx.doi.org/10.1111/os.13113
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