Chen LP, Wen BS, Xu H, Lu Z, Yan LJ, Deng H, Fu HB, Yuan HJ, Hu PP. Coaxial radiography guided puncture technique for percutaneous transforaminal endoscopic lumbar discectomy: A randomized control trial. World J Clin Cases 2023; 11(16): 3802-3812 [PMID: 37383116 DOI: 10.12998/wjcc.v11.i16.3802]
Corresponding Author of This Article
Hong-Jie Yuan, MD, Doctor, Department of Pain Management, Nantong Hospital of Traditional Chinese Medicine, No. 41 Jianshe Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. yuanhongjie81@foxmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2023; 11(16): 3802-3812 Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3802
Coaxial radiography guided puncture technique for percutaneous transforaminal endoscopic lumbar discectomy: A randomized control trial
Li-Ping Chen, Bin-Song Wen, Heng Xu, Zheng Lu, Lai-Jun Yan, Han Deng, Hong-Bo Fu, Hong-Jie Yuan, Pei-Pei Hu
Li-Ping Chen, Heng Xu, Department of Pain Management, The Affiliated Hospital of Xuzhou Medical College, Xuzhou 221000, Jiangsu Province, China
Bin-Song Wen, Lai-Jun Yan, Han Deng, Hong-Bo Fu, Hong-Jie Yuan, Pei-Pei Hu, Department of Pain Management, Nantong Hospital of Traditional Chinese Medicine, Nantong 226000, Jiangsu Province, China
Zheng Lu, Department of Neurosurgery, Haian People's Hospital, Nantong 226001, Jiangsu Province, China
Author contributions: Yuan HJ, Chen LP, and Xu H designed the research study; Yuan HJ and Chen LP performed the procedure; Hu PP, Fu HB, and Xu H recorded the outcomes; Wen BS, Deng H, and Lu Z did the statistical work, Wen BS, Yan LJ, and Yuan HJ wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: This study complied with The Declaration of Helsinki, and the trial was approved by the Institutional Ethics Committee of Clinical Research of Nantong Hospital of Traditional Chinese Medicine (Approval No. 20221230-5).
Clinical trial registration statement: The clinical trial was registered on the Chinese Clinical Trial Registry website (Registration number ChiCTR2200058894).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no potential conflicting interests related to this paper.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Jie Yuan, MD, Doctor, Department of Pain Management, Nantong Hospital of Traditional Chinese Medicine, No. 41 Jianshe Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. yuanhongjie81@foxmail.com
Received: December 11, 2022 First decision: January 30, 2023 Revised: February 19, 2023 Accepted: April 19, 2023 Article in press: April 19, 2023 Published online: June 6, 2023 Processing time: 173 Days and 8.5 Hours
ARTICLE HIGHLIGHTS
Research background
As a conventional puncture technique in endoscopic discectomy, anterior-posterior and lateral radiography-guided puncture technique (AP-PT) has limitations, such as repeated intermittent radiographs and inaccurate needle angulation. Although some innovative puncturing techniques have been reported, most of them require additional equipment. This paper describes an innovative coaxial radiography-guided puncture technique (CR-PT) and verifies its feasibility and superiority compared to the traditional AP-PT technique.
Research motivation
The coaxial radiography-guided puncture technique (CR-PT) is commonly applied in conventional procedures; however, we applied this technique in endoscopic lumbar discectomies. For some difficult cases, a guiding needle was used and the tip of the guiding needle was set as the target, which subsequently enabled the coaxial puncture technique to be performed.
Research objectives
The aim of the research was to verify the superiority of CR-PT over AP-PT in endoscopic lumbar discectomies.
Research methods
This is an RCT trial. The participants were assigned to either a CR-PT group or an AP-PT group. The number of fluoroscopies during puncturing, puncture duration (min), surgery duration (min), VAS score during puncturing, and puncture success rate were recorded and compared.
Research results
The trial verified the superiority of CR-PT over AP-PT in terms of puncture duration, puncture accuracy, and VAS score during puncturing.
Research conclusions
The CR-PT technique is a novel and effective technique. This technique significantly improves puncture accuracy and shortens puncture duration. Therefore, CR-PT could be an advisable option in endoscopic discectomy.
Research perspectives
This study lays a foundation for further research on the CR-PT technique in trans-interlaminar endoscopic lumbar discectomies and endoscopic cervical discectomies.
