Significance of preoperative planning software for puncture and channel establishment in percutaneous endoscopic lumbar DISCECTOMY: A study of 40 cases.
BACKGROUND
Preoperative planning software has been widely used in many other minimally invasive surgeries, but there is a lack of information describing the clinical benefits of existing software applied in percutaneous endoscopic lumbar discectomy (PELD). This study aimed to compare the clinical efficacy of preoperative planning software in puncture and channel establishment of PELD with routine methods in treating lumbar disc herniation (LDH).


METHODS
From June 2016 to October 2016, 40 patients who had single L4/5 or L5/S1 disc herniation were divided into two groups. Group A adopted planning software for preoperative puncture simulation while Group B took routine cases discussion for making puncture plans. The channel establishment time, operative time, fluoroscopic times and complications were compared between the two groups. The surgical efficacy was evaluated according to the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and modified Macnab's criteria.


RESULTS
The mean channel establishment time was 25.1 ± 4.2 min and 34.6 ± 5.4 min in Group A and B, respectively (P < 0.05). The mean operative time was 80.8 ± 8.4 min and 92.1 ± 7.3 min in Group A and B, respectively (P < 0.05). The fluoroscopic times were 21.5 ± 5.2 in Group A and 29.3 ± 5.5 in Group B (P < 0.05). There were no significant differences in VAS and ODI scorings between the two groups either preoperatively or postoperatively (P > 0.05). The findings of modified Macnab's criteria at each follow-up also showed no significant differences (P > 0.05).


CONCLUSIONS
The application of preoperative planning software in puncture and cannula insertion planning in PELD was easy and reliable, and could reduce the channel establishment time, operative time and fluoroscopic times of PELD significantly.
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China. Electronic address: huzhouyang1991@163.com.
Zhouyang
Z
Hu
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Xinhua
X
Li
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Jian
J
Cui
Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Xiaobo
X
He
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Cong
C
Li
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Yingchao
Y
Han
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Jie
J
Pan
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Mingjie
M
Yang
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China.
Jun
J
Tan
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, PR China. Electronic address: liliju@163.com.
Lijun
L
Li
D000328:Adult; D020000:Decision Support Systems, Clinical; D017587:Diskectomy, Percutaneous / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D011184:Postoperative Period; D057234:Preoperative Period; D011677:Punctures / Q000379:methods; D012189:Retrospective Studies; D012984:Software; D016896:Treatment Outcome
Channel establishment; Lumbar disc herniation; Percutaneous endoscopic lumbar discectomy; Preoperative planning software