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

Autor: Rui Wang, Ze Yan Liang, Xin Yao Chen, Chun Mei Chen
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Orthopaedic Surgery, Vol 14, Iss 1, Pp 104-110 (2022)
Druh dokumentu: article
ISSN: 1757-7861
1757-7853
DOI: 10.1111/os.13113
Popis: 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
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