Improvement And Application Of A Preoperative Location Method Of Percutaneous Endoscopic Lumbar Discectomy

Objective:To explore a novel preoperative location method which was more time-saving and effective than traditional preoperative location method of percutaneous endoscopic lumbar discectomy(PELD).Compared with traditional preoperative localization methods,new method has a greater advantage of the learning curve,the fluoroscopy times,and body mass index of patients and so on.To a certain extent,it is convenient for beginners learning PELD technology,at the same time,reducing the radiation exposure of patients and surgeons,ensuring the health of patients and surgeons.Methods:From July 2016 to September 2017,60 patients with lumbar disc herniation(LDH)received surgical treatment in our department.According to the difference of preoperative location method,30 patients were surgically treated by traditional method(Group A),including 3 cases of L3/4,22 cases of L4/5,and 5 cases of L5/S1.While 30 patients underwent operation by novel method(Group B),including 2 cases of L3/4,24 cases of L4/5,and 4 cases of L5/S1.Both groups of patients had only a single segmental symptom.The imagings were consistent with the neurological manifestations of the patients.Strict conservative treatment was ineffective or worse.In order to reduce the influences to preoperative location of subjective factors,all operations were performed by a single,experienced surgeon.The statistical differences of sex,age,body mass index(BMI),lesion segment distribution and preoperative visual analogue scale(VAS)between the two groups were evaluated in detail before operation.The fluoroscopy times,preoperative location time,and operation time were thoroughly recorded and analyzed.The novel method had obvious advantages compared with traditional location method.Results:All patients were complete data collection and statistical analysis.The fluoroscopy time of Group A was(15.63±3.61)and that of Group B was(12.20±3.67).The preoperative location time of Group A was(16.62 ± 2.45)mins and that of Group B was(11.51 ± 1.50)mins.The operation time of Group A was(65.73±4.09)mins and that of Group B was(58.49±3.87)mins.There were no significant differences in gender,age,BMI and lesion segment distribution in each group.There was no significant difference in preoperative and postoperative VAS scores between the two groups(P>0.05),and the difference in preoperative VAS scores between the two groups was significant(P<0.05),indicating that the two groups achieved good results in surgery.The fluoroscopy times,preoperative location time,and operation time were obviously decreased in comparison with those in Group A.Two groups were significantly different(P<0.05).Conclusion:Compared with traditional method,the fluoroscopy times,preoperative location time,and operation time were significantly shorter in patients with novel method.It not only relieves the patients' pain,but also allows the doctor and the patient to be exposed to the fluoroscopy as little as possible,which can decrease the amount of radiation and let them more safe work.