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International Orthopaedics

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01-02-2017 | Original Paper

Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy

Authors: Guoxin Fan, Ruoshuang Han, Xin Gu, Hailong Zhang, Xiaofei Guan, Yunshan Fan, Teng Wang, Shisheng He

Published in: International Orthopaedics | Issue 2/2017

Abstract

Purpose

Beginners usually need increased punctures and dozens of fluoroscopy in learning transforamimal percutaneous endoscopic lumbar discectomy (tPELD). Navigator-assisted spinal surgery (NASS) is a novel technique that could induce a definite trajectory. The retrospective study aimed to investigate the impact of a definite trajectory on the learning curve of tPELD.

Methods

A total of 120 patients with symptomatic lumbar disc herniation who received tPELD between 2012 and 2014. Patients receiving tPELD with NASS technique by one surgeon were regarded as group A, and those receiving conventional methods by another surgeon were regarded as group B. Each group was divided into three subgroups (case 1–20, case 21–40, case 41–60).

Results

The fluoroscopy times were 22.62 ± 3.80 in group A and 34.32 ± 4.78 in group B (P < 0.001). The pre-operative location time was 3.56 ± 0.60 minutes in group A and 5.49 ± 1.48 minutes in group B (P < 0.001). The puncture-channel time was 21.85 ± 4.31 minutes in group A and 34.20 ± 8.88 minutes in group B (P < 0.001). The operation time was 84.62 ± 9.20 minutes in group A and 101.97 ± 14.92 minutes in group B (P < 0.001), and the learning curve of tPELD in group A was steeper than that in group B. No significant differences were detected in patient-reported outcomes, hospital stay, patient satisfaction, and complication rate between the two groups (p > 0.05).

Conclusions

Definite trajectory significantly reduced the operation time, preoperative location time, puncture-channel time, and fluoroscopy times of tPELD by beginners, and thus reshaped the learning curve of tPELD and minimized the radiation exposure.

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Title: Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy
Authors: Guoxin Fan
Ruoshuang Han
Xin Gu
Hailong Zhang
Xiaofei Guan
Yunshan Fan
Teng Wang
Shisheng He
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 2/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-016-3281-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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