Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes
Abstract Objective Percutaneous transforaminal endoscopic discectomy (PTED) is minimally invasive and has been widely used to treat patients with lumbar disc herniation (LDH) due to its safety and efficiency. However, due to the unique anatomy of the L5–S1 level, the PTED procedure is often difficul...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02533-z |
| _version_ | 1811280569904922624 |
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| author | Jinlong Liu Junlong Wu Honglei Zhang Rui Zuo Jiabin Liu Chao Zhang |
| author_facet | Jinlong Liu Junlong Wu Honglei Zhang Rui Zuo Jiabin Liu Chao Zhang |
| author_sort | Jinlong Liu |
| collection | DOAJ |
| description | Abstract Objective Percutaneous transforaminal endoscopic discectomy (PTED) is minimally invasive and has been widely used to treat patients with lumbar disc herniation (LDH) due to its safety and efficiency. However, due to the unique anatomy of the L5–S1 level, the PTED procedure is often difficult to perform in the region. ZESSYS, a targeted and quantificational foraminoplasty device, may help to overcome these anatomical limitations. In this study, we assessed the efficiency and the short-term effects of PTED with ZESSYS at the L5–S1 level. Methods Between January and August of 2018, fifty-six patients with lumbar disc herniation at the single level of L5–S1 and who underwent percutaneous transforaminal endoscopic discectomy were enrolled in this retrospective cohort study. They were segregated into the transforaminal endoscopic surgical system (TESSYS) group and the ZESSYS group. The puncture time, foraminoplasty time, decompression time, and fluoroscopy time were evaluated for operation efficiency. Clinical outcomes were assessed by the visual analog scale (VAS) score and Oswestry Disability Index (ODI) score. The MacNab criteria were used to evaluate patient subjective satisfaction at 12-month follow-up postoperatively. Results The average puncture time (5.29 ± 2.05 min), foraminoplasty time (12.82 ± 2.52 min), and fluoroscopy time (26.29 ± 5.96 s) were all significantly shorter in the ZESSYS group than in the TESSYS group (average puncture time 8.07 ± 3.13 min, p < 0.01; foraminoplasty time, 17.18 ± 2.92 min, p < 0.01; fluoroscopy time, 34.73 ± 6.86 s; p < 0.01). No significant differences were observed between the 2 groups in the decompression time (p = 0.057). The VAS score of low back pain and leg pain, as well as the ODI score, improved at all time points postoperatively compared with preoperative, in both the TESSYS group and the ZESSYS group (P < 0.05). There were no significant differences in the VAS score of low back pain, VAS score of leg pain, and ODI score between the TESSYS group and the ZESSYS group at the same time points (P > 0.05). According to the MacNab criteria, the excellent and good rate at 12-month follow-up postoperatively was 85.7% in the TESSYS group and 89.3% in the ZESSYS group (P > 0.05). Conclusion The targeted and quantificational foraminoplasty device named ZESSYS was more efficient in the puncture and foraminoplasty procedures, effectively protecting the exiting nerve and minimizing the level of radiation exposure. The device is efficient and safe for PTED in treating lumbar disc herniation at the L5–S1 level. |
| first_indexed | 2024-04-13T01:17:05Z |
| format | Article |
| id | doaj.art-e65ffe85e54f4d8aad07cab05092bad9 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T01:17:05Z |
| publishDate | 2021-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e65ffe85e54f4d8aad07cab05092bad92022-12-22T03:08:54ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-06-011611910.1186/s13018-021-02533-zApplication of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomesJinlong Liu0Junlong Wu1Honglei Zhang2Rui Zuo3Jiabin Liu4Chao Zhang5Department of Spine Surgery, People’s Hospital of LiaochengDepartment of Orthopaedics, The 941th Hospital of Joint Logistics Support Force of Chinese PLADepartment of Spine Surgery, People’s Hospital of LiaochengDepartment of Spine Surgery, Xinqiao Hospital, Army Medical UniversityDepartment of Spine Surgery, Xinqiao Hospital, Army Medical UniversityDepartment of Spine Surgery, Xinqiao Hospital, Army Medical UniversityAbstract Objective Percutaneous transforaminal endoscopic discectomy (PTED) is minimally invasive and has been widely used to treat patients with lumbar disc herniation (LDH) due to its safety and efficiency. However, due to the unique anatomy of the L5–S1 level, the PTED procedure is often difficult to perform in the region. ZESSYS, a targeted and quantificational foraminoplasty device, may help to overcome these anatomical limitations. In this study, we assessed the efficiency and the short-term effects of PTED with ZESSYS at the L5–S1 level. Methods Between January and August of 2018, fifty-six patients with lumbar disc herniation at the single level of L5–S1 and who underwent percutaneous transforaminal endoscopic discectomy were enrolled in this retrospective cohort study. They were segregated into the transforaminal endoscopic surgical system (TESSYS) group and the ZESSYS group. The puncture time, foraminoplasty time, decompression time, and fluoroscopy time were evaluated for operation efficiency. Clinical outcomes were assessed by the visual analog scale (VAS) score and Oswestry Disability Index (ODI) score. The MacNab criteria were used to evaluate patient subjective satisfaction at 12-month follow-up postoperatively. Results The average puncture time (5.29 ± 2.05 min), foraminoplasty time (12.82 ± 2.52 min), and fluoroscopy time (26.29 ± 5.96 s) were all significantly shorter in the ZESSYS group than in the TESSYS group (average puncture time 8.07 ± 3.13 min, p < 0.01; foraminoplasty time, 17.18 ± 2.92 min, p < 0.01; fluoroscopy time, 34.73 ± 6.86 s; p < 0.01). No significant differences were observed between the 2 groups in the decompression time (p = 0.057). The VAS score of low back pain and leg pain, as well as the ODI score, improved at all time points postoperatively compared with preoperative, in both the TESSYS group and the ZESSYS group (P < 0.05). There were no significant differences in the VAS score of low back pain, VAS score of leg pain, and ODI score between the TESSYS group and the ZESSYS group at the same time points (P > 0.05). According to the MacNab criteria, the excellent and good rate at 12-month follow-up postoperatively was 85.7% in the TESSYS group and 89.3% in the ZESSYS group (P > 0.05). Conclusion The targeted and quantificational foraminoplasty device named ZESSYS was more efficient in the puncture and foraminoplasty procedures, effectively protecting the exiting nerve and minimizing the level of radiation exposure. The device is efficient and safe for PTED in treating lumbar disc herniation at the L5–S1 level.https://doi.org/10.1186/s13018-021-02533-zPercutaneous transforaminal endoscopic discectomyLumbar disc herniation at the L5–S1 levelForaminoplastyPreliminary clinical outcomes |
| spellingShingle | Jinlong Liu Junlong Wu Honglei Zhang Rui Zuo Jiabin Liu Chao Zhang Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes Journal of Orthopaedic Surgery and Research Percutaneous transforaminal endoscopic discectomy Lumbar disc herniation at the L5–S1 level Foraminoplasty Preliminary clinical outcomes |
| title | Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes |
| title_full | Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes |
| title_fullStr | Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes |
| title_full_unstemmed | Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes |
| title_short | Application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for L5–S1 disc herniation: preliminary clinical outcomes |
| title_sort | application of a targeted and quantificational foraminoplasty device in percutaneous transforaminal endoscopic discectomy for l5 s1 disc herniation preliminary clinical outcomes |
| topic | Percutaneous transforaminal endoscopic discectomy Lumbar disc herniation at the L5–S1 level Foraminoplasty Preliminary clinical outcomes |
| url | https://doi.org/10.1186/s13018-021-02533-z |
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