| Objective: O-arm Computed Tomography Navigation(OCTN) is new equipment of minimally invasive neural spine surgery.This study is to evalute the outcome of Percutaneous Endosopic Lumbar disc resection which is guided by OCTN for Lumbar Disc Herniation and assesses the safty and efficacy of PELD.Besides,OTCN has its own advantages in spinal endoscopic application.Methods:The records from 78 consecutive patients treated with percutaneous endoscopic lumbar discectomy were retrospectively reviewed. Clinical outcomes were assessed using the visual analog scale and MacNab criteria. The patients were divided to favorable and unfavorable group, according to the scores of visual analog scale decreased to 50% in post-operative. The lumbar disc herniation’s kind, level and nerve root compressed were evaluated as outcome predictors by chi-square test. P values < 0.05 were regarded as statistically significant.Results: Based on the MacNab criteria, the global outcomes were excellent in38.5%(30/78) patients, good in 44.9%(35/78) patients, fair in 8.9%(7/78) patients,and poor in 7.7%(6/78) patients. The visual analog scale were significantly improved,from 6.9±1.6 to 2.1±2.4. 73.1 %( 57/78) patients’ scores of the visual analog scale were decreased more than 50%. 38.9%(7/18) patients’ outcome was unfavorable in mutli-level lumbar disc herniation with nerve root compressed, compared with 81.6%(31/38) in sigle level lumbar disc herniation and 90.5%(19/22) in mutli-level lumbardisc herniation without nerve root compressed(P=0.003). The outcome were no different between the various lumbar disc herniation for lumbar canal location(P=0.127). There were cerebrospinal fluid leak in 1 patient. 15.4%(12/78)complained of postoperative dysesthesia, which improved with 2 months. There was no permanent complication.Conclusion:PELD guided by OCTN for lumbar disc herniation is safe and effective.OCTN has its unique advantages in PELD,such as three-dimensional imaging and high quality imaging resolution like CT. |
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