Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty

Ruixin Zhen; Fanqi Shi; Yubo Li; Honglian Zhao

doi:doi:10.11648/j.wjmcr.20230404.12

Research/Technical Note |

| Peer-Reviewed

Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty

Ruixin Zhen^*, Fanqi Shi, Yubo Li, Honglian Zhao

Published in World Journal of Medical Case Reports (Volume 4, Issue 4)

Received: 20 November 2023 Accepted: 13 December 2023 Published: 26 December 2023

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Transforaminal total endoscopic lumbar discectomy (TELD) is a typical minimally invasive procedure that has been successfully used in patients with different types of lumbar disc herniation in recent years. However, the procedure has a steep learning curve. External channel positioning system changes the blind technique of traditional foraminoplasty, which relies on fluoroscopy for repeated evaluation, and makes it a new technique that relies on mechanical operation and objective evaluation, thereby improving safety and reducing learning curve. The application is now reported. Objective: To explore the impact of external channel location system (ECLS) for the improvement of intraoperative parameters and surgical outcomes of foraminal enlargement plasty (FEP) in patients with lumbar disc herniation (LDH). Methods: This prospective case series study enrolled patients with LDH who scheduled for FEP in the Affiliated Hospital of Chengde Medical College between February 2021 and February 2022. The intraoperative parameters and surgical outcomes included nerve root and dural injury, puncture localization and postoperative and preoperative pain (visual analog scale, VAS, and Oswestry disability index, ODI). Results: Eighteen patients were enrolled for analysis. None showed nerve root and dural injury after 3 months, and without recurrence reported. There were 17 (94.4%) patients had a successful puncture localization in one procedure. No significant difference between percent (P) 25 and P75 values of the duration of puncture localization, number of X-ray sessions required for puncture localization, and the duration of operation were observed (all P > 0.05). Postoperative VAS (1.45 ± 0.99 and 6.65 ± 2.08) and ODI (0.13 ± 0.06 and 0.73 ± 0.07) scores were significantly decreased compared with preoperative values (P < 0.05). According to the modified Macnab criteria, 8 and 10 cases had excellent and good outcomes, respectively. Conclusion: ECLS might have favorable improvement for intraoperative parameters and outcomes of FEP.

Published in	World Journal of Medical Case Reports (Volume 4, Issue 4)
DOI	10.11648/j.wjmcr.20230404.12
Page(s)	48-55
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

External Channel Location System, Foraminal Enlargement Plasty, Puncture Localization, Case Series

References

[1]	Amin RM, Andrade NS, Neuman BJ. Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017. 10(4): 507-16.
[2]	Yoshinari H, Tezuka F, Yamashita K, et al. Transforaminal full-endoscopic lumbar discectomy under local anesthesia in awake and aware conditions: the inside-out and outside-in techniques. Curr Rev Musculoskelet Med. 2019. 12(3): 311-7. doi: 10.1007/s12178-019-09565-3. Epub ahead of print. PMID: 31236834; PMCID: PMC6684726.
[3]	Ao S, Wu J, Tang Y, et al. Percutaneous Endoscopic Lumbar Discectomy Assisted by O-Arm-Based Navigation Improves the Learning Curve. Biomed Res Int. 2019. 2019: 6509409.
[4]	Gu S, Hou K, Jian W, Du J, Xiao S, Zhang X. Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note. Biomed Res Int. 2018. 2018: 4749560.
[5]	Lee HJ, Kim JS, Ryu KS. Transforaminal Percutaneous Endoscopic Lumbar Diskectomy with Percutaneous Epidural Neuroplasty in Lumbar Disk Herniation: Technical Note. World Neurosurg. 2017. 98: 876. e23-876. e31.
[6]	Ahn SS, Kim SH, Kim DW. Learning Curve of Percutaneous Endoscopic Lumbar Discectomy Based on the Period (Early vs. Late) and Technique (in-and-out vs.in-and-out-and-in): A Retrospective Comparative Study. J Korean Neurosurg Soc. 2015. 58(6): 539-46.
[7]	Gibson JN, Cowie JG, Iprenburg M. Transforaminal endoscopic spinal surgery: the future 'gold standard' for discectomy? - A review. Surgeon. 2012. 10(5): 290-6.
[8]	Yeung AT. Minimally Invasive Disc Surgery with the Yeung Endoscopic Spine System (YESS). Surg Technol Int. 1999; 8: 267-77.
[9]	Choi KC, Kim JS, Park CK. Percutaneous Endoscopic Lumbar Discectomy as an Alternative to Open Lumbar Microdiscectomy for Large Lumbar Disc Herniation. Pain Physician. 2016. 19(2): E291-300.
[10]	Yoon SM, Ahn SS, Kim KH, Kim YD, Cho JH, Kim DH. Comparative Study of the Outcomes of Percutaneous Endoscopic Lumbar Discectomy and Microscopic Lumbar Discectomy Using the Tubular Retractor System Based on the VAS, ODI, and SF-36. Korean J Spine. 2012. 9(3): 215-22.
[11]	Wu J, Zhang C, Zheng W, Hong CS, Li C, Zhou Y. Analysis of the Characteristics and Clinical Outcomes of Percutaneous Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniation. World Neurosurg. 2016. 92: 142-147.
[12]	Ahn Y, Kim CH, Lee JH, Lee SH, Kim JS. Radiation exposure to the surgeon during percutaneous endoscopic lumbar discectomy: a prospective study. Spine (Phila Pa 1976). 2013. 38(7): 617-25.
[13]	Fan G, Gu X, Liu Y, et al. Lower Learning Difficulty and Fluoroscopy Reduction of Transforaminal Percutaneous Endoscopic Lumbar Discectomy with an Accurate Preoperative Location Method. Pain Physician. 2016. 19(8): E1123-E1134.
[14]	Kaminski L, Cordemans V, Cartiaux O, Van Cauter M. Radiation exposure to the patients in thoracic and lumbar spine fusion using a new intraoperative cone-beam computed tomography imaging technique: a preliminary study. Eur Spine J. 2017. 26(11): 2811-2817.
[15]	Prasarn ML, Coyne E, Schreck M, Rodgers JD, Rechtine GR. Comparison of image quality and radiation exposure from C-arm fluoroscopes when used for imaging the spine. Spine (Phila Pa 1976). 2013. 38(16): 1401-4.
[16]	Plastaras C, Appasamy M, Sayeed Y, et al. Fluoroscopy procedure and equipment changes to reduce staff radiation exposure in the interventional spine suite. Pain Physician. 2013. 16(6): E731-8.
[17]	Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976). 2002. 27(7): 722-31.
[18]	Sairyo K, Chikawa T, Nagamachi A. State-of-the-art transforaminal percutaneous endoscopic lumbar surgery under local anesthesia: Discectomy, foraminoplasty, and ventral facetectomy. J Orthop Sci. 2018. 23(2): 229-236.
[19]	Hoogland T, Schubert M, Miklitz B, Ramirez A. Transforaminal posterolateral endoscopic discectomy with or without the combination of a low-dose chymopapain: a prospective randomized study in 280 consecutive cases. Spine (Phila Pa 1976). 2006. 31(24): E890-7.
[20]	Sairyo K, Egawa H, Matsuura T, et al. State of the art: Transforaminal approach for percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Invest. 2014. 61(3-4): 217-25.
[21]	Wei S, Tao W, Zhu H, Li Y. Three-dimensional intraoperative imaging with O-arm to establish a working trajectory in percutaneous endoscopic lumbar discectomy. Wideochir Inne Tech Maloinwazyjne. 2016. 10(4): 555-60.
[22]	Choi G, Modi HN, Prada N, et al. Clinical results of XMR-assisted percutaneous transforaminal endoscopic lumbar discectomy. J Orthop Surg Res. 2013. 8: 14.
[23]	Wu RH, Deng DH, Huang XQ, Shi CL, Liao XQ. Radiation Exposure Reduction in Ultrasound-Guided Transforaminal Percutaneous Endoscopic Lumbar Discectomy for Lumbar Disc Herniation: A Randomized Controlled Trial. World Neurosurg. 2019.
[24]	Schubert M, Hoogland T. Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation. Oper Orthop Traumatol. 2005. 17(6): 641-61.

Cite This Article

Plain Text BibTeX RIS

APA Style

Zhen, R., Shi, F., Li, Y., Zhao, H. (2023). Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World Journal of Medical Case Reports, 4(4), 48-55. https://doi.org/10.11648/j.wjmcr.20230404.12

Copy | Download

ACS Style

Zhen, R.; Shi, F.; Li, Y.; Zhao, H. Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World J. Med. Case Rep. 2023, 4(4), 48-55. doi: 10.11648/j.wjmcr.20230404.12

Copy | Download

AMA Style

Zhen R, Shi F, Li Y, Zhao H. Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World J Med Case Rep. 2023;4(4):48-55. doi: 10.11648/j.wjmcr.20230404.12

Copy | Download

@article{10.11648/j.wjmcr.20230404.12,
  author = {Ruixin Zhen and Fanqi Shi and Yubo Li and Honglian Zhao},
  title = {Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty},
  journal = {World Journal of Medical Case Reports},
  volume = {4},
  number = {4},
  pages = {48-55},
  doi = {10.11648/j.wjmcr.20230404.12},
  url = {https://doi.org/10.11648/j.wjmcr.20230404.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20230404.12},
  abstract = {Transforaminal total endoscopic lumbar discectomy (TELD) is a typical minimally invasive procedure that has been successfully used in patients with different types of lumbar disc herniation in recent years. However, the procedure has a steep learning curve. External channel positioning system changes the blind technique of traditional foraminoplasty, which relies on fluoroscopy for repeated evaluation, and makes it a new technique that relies on mechanical operation and objective evaluation, thereby improving safety and reducing learning curve. The application is now reported. Objective: To explore the impact of external channel location system (ECLS) for the improvement of intraoperative parameters and surgical outcomes of foraminal enlargement plasty (FEP) in patients with lumbar disc herniation (LDH). Methods: This prospective case series study enrolled patients with LDH who scheduled for FEP in the Affiliated Hospital of Chengde Medical College between February 2021 and February 2022. The intraoperative parameters and surgical outcomes included nerve root and dural injury, puncture localization and postoperative and preoperative pain (visual analog scale, VAS, and Oswestry disability index, ODI). Results: Eighteen patients were enrolled for analysis. None showed nerve root and dural injury after 3 months, and without recurrence reported. There were 17 (94.4%) patients had a successful puncture localization in one procedure. No significant difference between percent (P) 25 and P75 values of the duration of puncture localization, number of X-ray sessions required for puncture localization, and the duration of operation were observed (all P > 0.05). Postoperative VAS (1.45 ± 0.99 and 6.65 ± 2.08) and ODI (0.13 ± 0.06 and 0.73 ± 0.07) scores were significantly decreased compared with preoperative values (P Conclusion: ECLS might have favorable improvement for intraoperative parameters and outcomes of FEP.
},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty
AU  - Ruixin Zhen
AU  - Fanqi Shi
AU  - Yubo Li
AU  - Honglian Zhao
Y1  - 2023/12/26
PY  - 2023
N1  - https://doi.org/10.11648/j.wjmcr.20230404.12
DO  - 10.11648/j.wjmcr.20230404.12
T2  - World Journal of Medical Case Reports
JF  - World Journal of Medical Case Reports
JO  - World Journal of Medical Case Reports
SP  - 48
EP  - 55
PB  - Science Publishing Group
SN  - 2994-726X
UR  - https://doi.org/10.11648/j.wjmcr.20230404.12
AB  - Transforaminal total endoscopic lumbar discectomy (TELD) is a typical minimally invasive procedure that has been successfully used in patients with different types of lumbar disc herniation in recent years. However, the procedure has a steep learning curve. External channel positioning system changes the blind technique of traditional foraminoplasty, which relies on fluoroscopy for repeated evaluation, and makes it a new technique that relies on mechanical operation and objective evaluation, thereby improving safety and reducing learning curve. The application is now reported. Objective: To explore the impact of external channel location system (ECLS) for the improvement of intraoperative parameters and surgical outcomes of foraminal enlargement plasty (FEP) in patients with lumbar disc herniation (LDH). Methods: This prospective case series study enrolled patients with LDH who scheduled for FEP in the Affiliated Hospital of Chengde Medical College between February 2021 and February 2022. The intraoperative parameters and surgical outcomes included nerve root and dural injury, puncture localization and postoperative and preoperative pain (visual analog scale, VAS, and Oswestry disability index, ODI). Results: Eighteen patients were enrolled for analysis. None showed nerve root and dural injury after 3 months, and without recurrence reported. There were 17 (94.4%) patients had a successful puncture localization in one procedure. No significant difference between percent (P) 25 and P75 values of the duration of puncture localization, number of X-ray sessions required for puncture localization, and the duration of operation were observed (all P > 0.05). Postoperative VAS (1.45 ± 0.99 and 6.65 ± 2.08) and ODI (0.13 ± 0.06 and 0.73 ± 0.07) scores were significantly decreased compared with preoperative values (P Conclusion: ECLS might have favorable improvement for intraoperative parameters and outcomes of FEP.

VL  - 4
IS  - 4
ER  -

Copy | Download

Author Information

Ruixin Zhen

Minimal Invasive Spinal Surgery, The Affiliated Hospital of Chengde Medical University, Chengde, China

Contact Email
Fanqi Shi

Minimal Invasive Spinal Surgery, The Affiliated Hospital of Chengde Medical University, Chengde, China
Yubo Li

Minimal Invasive Spinal Surgery, The Affiliated Hospital of Chengde Medical University, Chengde, China
Honglian Zhao

Operation Department, The Affiliated Hospital of Chengde Medical University, Chengde, China

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Zhen, R., Shi, F., Li, Y., Zhao, H. (2023). Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World Journal of Medical Case Reports, 4(4), 48-55. https://doi.org/10.11648/j.wjmcr.20230404.12

Copy | Download

ACS Style

Zhen, R.; Shi, F.; Li, Y.; Zhao, H. Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World J. Med. Case Rep. 2023, 4(4), 48-55. doi: 10.11648/j.wjmcr.20230404.12

Copy | Download

AMA Style

Zhen R, Shi F, Li Y, Zhao H. Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty. World J Med Case Rep. 2023;4(4):48-55. doi: 10.11648/j.wjmcr.20230404.12

Copy | Download

@article{10.11648/j.wjmcr.20230404.12,
  author = {Ruixin Zhen and Fanqi Shi and Yubo Li and Honglian Zhao},
  title = {Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty},
  journal = {World Journal of Medical Case Reports},
  volume = {4},
  number = {4},
  pages = {48-55},
  doi = {10.11648/j.wjmcr.20230404.12},
  url = {https://doi.org/10.11648/j.wjmcr.20230404.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20230404.12},
  abstract = {Transforaminal total endoscopic lumbar discectomy (TELD) is a typical minimally invasive procedure that has been successfully used in patients with different types of lumbar disc herniation in recent years. However, the procedure has a steep learning curve. External channel positioning system changes the blind technique of traditional foraminoplasty, which relies on fluoroscopy for repeated evaluation, and makes it a new technique that relies on mechanical operation and objective evaluation, thereby improving safety and reducing learning curve. The application is now reported. Objective: To explore the impact of external channel location system (ECLS) for the improvement of intraoperative parameters and surgical outcomes of foraminal enlargement plasty (FEP) in patients with lumbar disc herniation (LDH). Methods: This prospective case series study enrolled patients with LDH who scheduled for FEP in the Affiliated Hospital of Chengde Medical College between February 2021 and February 2022. The intraoperative parameters and surgical outcomes included nerve root and dural injury, puncture localization and postoperative and preoperative pain (visual analog scale, VAS, and Oswestry disability index, ODI). Results: Eighteen patients were enrolled for analysis. None showed nerve root and dural injury after 3 months, and without recurrence reported. There were 17 (94.4%) patients had a successful puncture localization in one procedure. No significant difference between percent (P) 25 and P75 values of the duration of puncture localization, number of X-ray sessions required for puncture localization, and the duration of operation were observed (all P > 0.05). Postoperative VAS (1.45 ± 0.99 and 6.65 ± 2.08) and ODI (0.13 ± 0.06 and 0.73 ± 0.07) scores were significantly decreased compared with preoperative values (P Conclusion: ECLS might have favorable improvement for intraoperative parameters and outcomes of FEP.
},
 year = {2023}
}

Copy | Download

TY  - JOUR
T1  - Application and Previous Report of External Channel Positioning System in Enlarged Foraminoplasty
AU  - Ruixin Zhen
AU  - Fanqi Shi
AU  - Yubo Li
AU  - Honglian Zhao
Y1  - 2023/12/26
PY  - 2023
N1  - https://doi.org/10.11648/j.wjmcr.20230404.12
DO  - 10.11648/j.wjmcr.20230404.12
T2  - World Journal of Medical Case Reports
JF  - World Journal of Medical Case Reports
JO  - World Journal of Medical Case Reports
SP  - 48
EP  - 55
PB  - Science Publishing Group
SN  - 2994-726X
UR  - https://doi.org/10.11648/j.wjmcr.20230404.12
AB  - Transforaminal total endoscopic lumbar discectomy (TELD) is a typical minimally invasive procedure that has been successfully used in patients with different types of lumbar disc herniation in recent years. However, the procedure has a steep learning curve. External channel positioning system changes the blind technique of traditional foraminoplasty, which relies on fluoroscopy for repeated evaluation, and makes it a new technique that relies on mechanical operation and objective evaluation, thereby improving safety and reducing learning curve. The application is now reported. Objective: To explore the impact of external channel location system (ECLS) for the improvement of intraoperative parameters and surgical outcomes of foraminal enlargement plasty (FEP) in patients with lumbar disc herniation (LDH). Methods: This prospective case series study enrolled patients with LDH who scheduled for FEP in the Affiliated Hospital of Chengde Medical College between February 2021 and February 2022. The intraoperative parameters and surgical outcomes included nerve root and dural injury, puncture localization and postoperative and preoperative pain (visual analog scale, VAS, and Oswestry disability index, ODI). Results: Eighteen patients were enrolled for analysis. None showed nerve root and dural injury after 3 months, and without recurrence reported. There were 17 (94.4%) patients had a successful puncture localization in one procedure. No significant difference between percent (P) 25 and P75 values of the duration of puncture localization, number of X-ray sessions required for puncture localization, and the duration of operation were observed (all P > 0.05). Postoperative VAS (1.45 ± 0.99 and 6.65 ± 2.08) and ODI (0.13 ± 0.06 and 0.73 ± 0.07) scores were significantly decreased compared with preoperative values (P Conclusion: ECLS might have favorable improvement for intraoperative parameters and outcomes of FEP.

VL  - 4
IS  - 4
ER  -

Copy | Download