ArticleAnnals of translational medicine2021
Puncture and localization for percutaneous endoscopic lumbar discectomy with C-arm navigation: a randomized controlled cadaver trial.
Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Trial
- Whole process navigated percutaneous endoscopic lumbar discectomy guided by a novel X-ray instant navigation: a technical report and preliminary clinical outcomes.BMC musculoskeletal disorders · 2025Article
- Novel anatomical landmark guided puncture method in L4/L5 spine posterior interlaminar endoscopic surgery: a technical note and case series.Frontiers in surgery · 2025Article
- Advances of surgical robotics: image-guided classification and application.National science review · 2024Review
- Coaxial radiography guided puncture technique for percutaneous transforaminal endoscopic lumbar discectomy: A randomized control trial.World journal of clinical cases · 2023Article
- Unilateral biportal endoscopic lumbar interbody fusion assisted by intraoperative O-arm total navigation for lumbar degenerative disease: A retrospective study.Frontiers in surgery · 2022Article
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10 authors.
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Abstract
backgroundAccurate preoperative puncture and localization is a key step in percutaneous endoscopic lumbar discectomy (PELD). This study investigated the benefit of puncture and localization for PELD by C-arm navigation over conventional methods.
methodsSixteen adult cadavers were randomly divided into two groups (group A defined as the C-arm navigation method, and group B defined as the conventional localization method). Two junior orthopedic surgeons who specialized in spinal surgeries were randomly allocated to each group. Conventional localization using C-arm fluoroscopy and localization using C-arm navigation were performed during the procedure. The intervertebral foramen on both sides at L3-L4, L4-L5, and L5-S1 levels were punctured using the two methods. Technical parameters, such as fluoroscopy time, puncture time, overall time taken for puncture and localization, as well as the number of fluoroscopies, number of puncture attempts, and success rate of the first puncture were compared between the two methods. The learning curves were plotted for the two methods, and correlations between all technical parameters were analyzed.
resultsPuncture and localization for PELD assisted by C-arm navigation had a flatter learning curve compared with the conventional localization method. The fluoroscopy, puncture, and total puncture-localization time for group A were 5.61 (±1.37), 2.29 (±1.22), and 9.78 (±2.66) minutes compared with 15.72 (±3.59), 4.87 (±1.70), and 20.59 (±4.79) minutes for group B, respectively (P<0.05). Fluoroscopy was used on average 5.15 (±1.34) times in group A and 20.04 (±5.05) times in group B (P<0.05). There was an average of 1.08 (±0.28) puncture attempts in group A compared with 4.67 (±1.88) attempts in group B (P<0.05). The success rate of the first puncture was 91.7% in group A and 10.4% in group B (P<0.05).
conclusionsPuncture and localization using C-arm navigation for PELD was shown to dramatically flatten the learning curve of junior surgeons and significantly improved the success rate of the first puncture. Moreover, PELD using C-arm navigation can minimize surgery time and the risk of radiation exposure for both patients and medical staff by reducing the number of fluoroscopies and puncture attempts.
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