机构:[1]Nanjing Univ Chinese Med, Dept Orthoped Surg, Suzhou TCM Hosp, Suzhou, Peoples R China[2]Guangzhou Univ Chinese Med, Guangzhou, Peoples R China[3]Guangzhou Med Univ, Affiliated TCM Hosp, Guangzhou, Peoples R China[4]Guangzhou Med Univ, Affiliated Hosp 2, Dept Spine Surg, Guangzhou, Peoples R China[5]Guangzhou Univ Chinese Med, Dept Spinal Surg, Affiliated Hosp 1, Guangzhou, Peoples R China[6]Dalian Univ Technol, Med Dept, Dalian, Peoples R China
Objective: Foraminoplasty is an important step in transforaminal endoscopic lumbar discectomy (TELD). A trephine is widely used in foraminoplasty. However, foraminoplasty using a trephine alone sometimes fails to remove the resected bone, resulting in the bone remaining in the foramen or spinal canal, which can potentially cause neurological irritation or injury. The objective of this study is to introduce a self-designed tool, referred to as an anchoring drill, for use with a trephine in foraminoplasty in TELD and to evaluate its advantages.Methods: A retrospective review was performed to identify patients who underwent L4-5 TELD between January 2019 to January 2022. Foraminoplasty was performed in all patients. Depending on whether the anchoring drill was used or not, patients were divided into two groups. Surgery-related parameters and complications were reviewed. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were also assessed for all patients. SPSS statistical software was used for statistical calculation.Results: A total of 100 patients were included (55 in the anchoring drill group and 45 in the trephine group). The incidence of residual bone fragments after foraminoplasty of the anchoring drill group was 9.09%, which was lower than that of the trephine group, at 33.33% (p < 0.05). The mean endoscopic operation time of the anchoring drill group was shorter than that of the trephine group (p < 0.05). The mean fluoroscopy time and duration of foraminoplasty showed no significant differences between the two cohorts. The total perioperative complication incidence was lower in the anchoring drill group, in which the neural irritation incidence showed a significant difference (anchoring drill group: 3.64%, trephine group: 17.78%, p < 0.05). VAS and JOA scores were significantly improved after the operation for all patients (p < 0.001), however, no statistical differences were found between the two groups at each follow-up visit.Conclusion: The combination of a trephine with an anchor drill was demonstrated to be safe and effective in foraminoplasty in TELD, improving the success rate of foraminoplasty and reducing neurological complications compared to using trephine alone.
基金:
Collaborative Innovation Team of "First-Rate Universities and Disciplines" and High-level University disciplines of Guangzhou University of Chinese Medicine [2021KCXTD017]; Innovation Team Project of the Department of Education of Guangdong Province; Collaborative Innovation Team of "First-Rate Universities [2021XK57]; High-Level University Disciplines of Guangzhou University of Chinese Medicine [20201097]; Scientific Research Project of the Traditional Chinese Medicine Bureau of Guangdong Province [JSDW202253, SZS2022019]; Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine of Jiangsu Provincial Health Commission [2022, 17]; Jiangsu Provincial Medical Key Discipline (Laboratory)
第一作者机构:[1]Nanjing Univ Chinese Med, Dept Orthoped Surg, Suzhou TCM Hosp, Suzhou, Peoples R China[2]Guangzhou Univ Chinese Med, Guangzhou, Peoples R China
通讯作者:
通讯机构:[4]Guangzhou Med Univ, Affiliated Hosp 2, Dept Spine Surg, Guangzhou, Peoples R China[5]Guangzhou Univ Chinese Med, Dept Spinal Surg, Affiliated Hosp 1, Guangzhou, Peoples R China[*1]16 Airport Rd, Guangzhou City 510405, Guangdong Provi, Peoples R China
推荐引用方式(GB/T 7714):
Zhu Guangye,He Jiahui,Song Zefeng,et al.Foraminoplasty Performed with a Trephine and a New Tool in Transforaminal Endoscopic Lumbar Discectomy: A Single-Center Retrospective Study[J].ORTHOPAEDIC SURGERY.2024,16(2):420-428.doi:10.1111/os.13978.
APA:
Zhu, Guangye,He, Jiahui,Song, Zefeng,Chen, Honglin,Ge, Zhilin...&Jiang, Xiaobing.(2024).Foraminoplasty Performed with a Trephine and a New Tool in Transforaminal Endoscopic Lumbar Discectomy: A Single-Center Retrospective Study.ORTHOPAEDIC SURGERY,16,(2)
MLA:
Zhu, Guangye,et al."Foraminoplasty Performed with a Trephine and a New Tool in Transforaminal Endoscopic Lumbar Discectomy: A Single-Center Retrospective Study".ORTHOPAEDIC SURGERY 16..2(2024):420-428