Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Lumbar Disc Herniation | Research article

A real-time 3D electromagnetic navigation system for percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation: a retrospective study

Authors: Boyu Wu, Tanjun Wei, Zhipeng Yao, Sai Yang, Yawei Yao, Chengwei Fu, Feng Xu, Chengjie Xiong

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

Background

In this study, we present a novel electromagnetic navigation (EMN) system for percutaneous transforaminal endoscopic discectomy (PTED) procedure. The objective of this study was to investigate the safety and effectiveness of the PTED with the assistance of the EMN system and compare it with the conventional PTED with the assistance of fluoroscopic guidance (C-arm).

Methods

The clinical data of 79 patients (32 in EMN group and 47 in C-arm group) undergoing PTED for lumbar disc herniation (LDH) from January to September of 2019 were analyzed retrospectively. The radiation time, puncture time, operation time, visual analog scale (VAS), Oswestry disability index (ODI), modified MacNab criteria, and radiological parameters were recorded in both groups.

Results

Radiation time, puncture time, and operation time were significantly reduced in the EMN group compared with the C-arm group (P < 0.05). Compared with the C-arm group, a steeper learning curve was observed in the EMN group. There were no significant differences between the two groups regarding VAS and ODI scores at different time points (P > 0.05). The satisfaction rates of the EMN and C-arm groups were 90.63 and 87.23%, respectively, but no significant difference was found between the two groups (P > 0.05). There was no significant difference regarding translation and angular motion between the two groups at preoperation and postoperation (P > 0.05).

Conclusions

The EMN system can be applied to facilitate the PETD procedure. It can significantly reduce the intraoperative radiation time, puncture time, and operation time, and reshape the learning curve of PTED. Due to limitations of a retrospective study, results may need validation with larger prospective randomized clinical trials.
Literature
1.
Patel PD, Canseco JA, Houlihan N, Gabay A, Grasso G, Vaccaro AR. Overview of minimally invasive spine surgery. World Neurosurg. 2020;142:43–56.CrossRef
2.
Momin AA, Steinmetz MP. Evolution of minimally invasive lumbar spine surgery. World Neurosurg. 2020;140:622–6.CrossRef
3.
Shawky Abdelgawaad A, Babic D, Siam AE, Ezzati A. Extraforaminal microscopic assisted percutaneous nucleotomy for foraminal and extraforaminal lumbar disc herniations. Spine J. 2018;18(4):620–5.CrossRef
4.
Li Z, Zhang C, Chen W, Li S, Yu B, Zhao H, et al. Percutaneous endoscopic Transforaminal discectomy versus conventional open lumbar discectomy for upper lumbar disc herniation: a comparative cohort study. Biomed Res Int. 2020;2020:1852070.PubMedPubMedCentral
5.
Tacconi L, Signorelli F, Giordan E. Is full endoscopic lumbar discectomy less invasive Than conventional surgery? A randomized MRI study. World Neurosurg. 2020;138:e867–75.CrossRef
6.
Ao S, Wu J, Zheng W, Zhou Y. A novel targeted Foraminoplasty device improves the efficacy and safety of Foraminoplasty in percutaneous endoscopic lumbar discectomy: preliminary clinical application of 70 cases. World Neurosurg. 2018;115:e263–71.CrossRef
7.
Gadjradj PS, van Tulder MW, Dirven CM, Peul WC, Harhangi BS. Clinical outcomes after percutaneous transforaminal endoscopic discectomy for lumbar disc herniation: a prospective case series. Neurosurg Focus. 2016;40(2):E3.CrossRef
8.
Ahn Y, Lee S, Son S, Kim H, Kim JE. Learning curve for Transforaminal percutaneous endoscopic lumbar discectomy: a systematic review. World Neurosurg. 2020;143:471–9.CrossRef
9.
Tenenbaum S, Arzi H, Herman A, Friedlander A, Levinkopf M, Arnold PM, et al. Percutaneous Posterolateral Transforaminal endoscopic discectomy: clinical outcome, complications, and learning curve evaluation. Surg Technol Int. 2011;21:278–83.PubMed
10.
Srinivasan D, Than KD, Wang AC, La Marca F, Wang PI, Schermerhorn TC, et al. Radiation safety and spine surgery: systematic review of exposure limits and methods to minimize radiation exposure. World Neurosurg. 2014;82(6):1337–43.CrossRef
11.
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.CrossRef
12.
Zhao Y, Bo X, Wang C, Hu S, Zhang T, Lin P, et al. Guided punctures with ultrasound volume navigation in percutaneous Transforaminal endoscopic discectomy: a technical note. World Neurosurg. 2018;119:77–84.CrossRef
13.
Ao S, Wu J, Tang Y, Zhang C, Li J, Zheng W, et al. Percutaneous endoscopic lumbar discectomy assisted by O-arm-based navigation improves the learning curve. Biomed Res Int. 2019;2019:6509409.CrossRef
14.
Lin Y, Rao S, Chen B, Zhao B, Wen T, Zhou L, et al. Electromagnetic navigation-assisted percutaneous endoscopic foraminoplasty and discectomy for lumbar disc herniation: technical note and preliminary results. Ann Palliat Med. 2020;9(6):3923–31.CrossRef
15.
Wood BJ, Zhang H, Durrani A, Glossop N, Ranjan S, Lindisch D, et al. Navigation with electromagnetic tracking for interventional radiology procedures: a feasibility study. J Vasc Interv Radiol. 2005;16(4):493–505.CrossRef
16.
Meyer BC, Peter O, Nagel M, Hoheisel M, Frericks BB, Wolf KJ, et al. Electromagnetic field-based navigation for percutaneous punctures on C-arm CT: experimental evaluation and clinical application. Eur Radiol. 2008;18(12):2855–64.CrossRef
17.
Bruners P, Penzkofer T, Nagel M, Elfring R, Gronloh N, Schmitz-Rode T, et al. Electromagnetic tracking for CT-guided spine interventions: phantom, ex-vivo and in-vivo results. Eur Radiol. 2009;19(4):990–4.CrossRef
18.
Schubert M, Hoogland T. Endoscopic transforaminal nucleotomy with foraminoplasty for lumbar disk herniation. Oper Orthop Traumatol. 2005;17(6):641–61.CrossRef
19.
Boden SD, Wiesel SW. Lumbosacral segmental motion in normal individuals. Have we been measuring instability properly? Spine (Phila Pa 1976). 1990;15(6):571–6.CrossRef
20.
Kanemura A, Doita M, Kasahara K, Sumi M, Kurosaka M, Iguchi T. The influence of sagittal instability factors on clinical lumbar spinal symptoms. J Spinal Disord Tech. 2009;22(7):479–85.CrossRef
21.
Zheng C, Wu F, Cai L. Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral lumbar disc herniations in children. Int Orthop. 2016;40(6):1099–102.CrossRef
22.
Kapetanakis S, Gkantsinikoudis N, Chaniotakis C, Charitoudis G, Givissis P. Percutaneous Transforaminal endoscopic discectomy for the treatment of lumbar disc herniation in obese patients: health-related quality of life assessment in a 2-year follow-up. World Neurosurg. 2018;113:e638–49.CrossRef
23.
Fan G, Han R, Gu X, Zhang H, Guan X, Fan Y, et al. Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy. Int Orthop. 2017;41(2):323–32.CrossRef
24.
Fan G, Wang C, Gu X, Zhang H, He S. Trajectory planning and guided punctures with Isocentric navigation in Posterolateral endoscopic lumbar discectomy. World Neurosurg. 2017;103:899–905.CrossRef
25.
Choi G, Modi HN, Prada N, Ahn TJ, Myung SH, Gang MS, et al. Clinical results of XMR-assisted percutaneous transforaminal endoscopic lumbar discectomy. J Orthop Surg Res. 2013;8:14.CrossRef
26.
Liu YB, Wang Y, Chen ZQ, Li J, Chen W, Wang CF, et al. Volume navigation with fusion of real-time ultrasound and CT images to guide Posterolateral Transforaminal puncture in percutaneous endoscopic lumbar discectomy. Pain Physician. 2018;21(3):E265–78.PubMed
27.
Zhang C, Wu J, Xu C, Zheng W, Pan Y, Li C, et al. Minimally invasive full-endoscopic posterior cervical Foraminotomy assisted by O-arm-based navigation. Pain Physician. 2018;21(3):E215–23.PubMed
28.
von Jako RA, Carrino JA, Yonemura KS, Noda GA, Zhue W, Blaskiewicz D, et al. Electromagnetic navigation for percutaneous guide-wire insertion: accuracy and efficiency compared to conventional fluoroscopic guidance. Neuroimage. 2009;47(Suppl 2):T127–32.CrossRef
29.
Wu J, Ao S, Liu H, Wang W, Zheng W, Li C, et al. Novel electromagnetic-based navigation for percutaneous transforaminal endoscopic lumbar decompression in patients with lumbar spinal stenosis reduces radiation exposure and enhances surgical efficiency compared to fluoroscopy: a randomized controlled trial. Ann Transl Med. 2020;8(19):1215.CrossRef
30.
Hayhurst C, Byrne P, Eldridge PR, Mallucci CL. Application of electromagnetic technology to neuronavigation: a revolution in image-guided neurosurgery. J Neurosurg. 2009;111(6):1179–84.CrossRef
31.
Hahn P, Oezdemir S, Komp M, Giannakopoulos A, Kasch R, Merk H, et al. Navigation of pedicle screws in the thoracic spine with a new electromagnetic navigation system: a human cadaver study. Biomed Res Int. 2015;2015:183586.CrossRef
32.
Hahn P, Oezdemir S, Komp M, Giannakopoulos A, Heikenfeld R, Kasch R, et al. A new electromagnetic navigation system for pedicle screws placement: a human cadaver study at the lumbar spine. PLoS One. 2015;10(7):e0133708.CrossRef
33.
Sagi HC, Manos R, Benz R, Ordway NR, Connolly PJ. Electromagnetic field-based image-guided spine surgery part one: results of a cadaveric study evaluating lumbar pedicle screw placement. Spine (Phila Pa 1976). 2003;28(17):2013–8.CrossRef
34.
Franke J, Greiner-Perth R, Boehm H, Mahlfeld K, Grasshoff H, Allam Y, et al. Comparison of a minimally invasive procedure versus standard microscopic discotomy: a prospective randomised controlled clinical trial. Eur Spine J. 2009;18(7):992–1000.CrossRef
Metadata
Title
A real-time 3D electromagnetic navigation system for percutaneous transforaminal endoscopic discectomy in patients with lumbar disc herniation: a retrospective study
Authors
Boyu Wu
Tanjun Wei
Zhipeng Yao
Sai Yang
Yawei Yao
Chengwei Fu
Feng Xu
Chengjie Xiong
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05012-6

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue

Research

The association between Roussouly sagittal alignment type and risk for adjacent segment degeneration following short-segment lumbar interbody fusion: a retrospective cohort study

Research

Factors associated with vitamin D deficiency among patients with musculoskeletal disorders seeking physiotherapy intervention: a hospital-based observational study

Research article

Impaired expression of BCAT1 relates to muscle atrophy of mouse model of sarcopenia

Research

Task-specific fear influences abnormal trunk motor coordination in workers with chronic low back pain: a relative phase angle analysis of object-lifting

Research

Prevalence of sarcopenia in community dwelling outpatient postmenopausal Hungarian women

Research

Postoperative proximal junctional kyphosis correlated with thoracic inlet angle in Lenke 5c adolescent idiopathic scoliosis patients following posterior surgery