Full-time and Real-time Visualized Lumbar Foraminoplasty ...
Transcript of Full-time and Real-time Visualized Lumbar Foraminoplasty ...
Full-time and Real-time Visualized Lumbar Foraminoplasty with V-type Bichannel Endoscopy (VBE)
Presenting author: Zhi Zhou
Co-authors: Zhi Zhou, Haijian Ni, Chuanfeng Wang, Yunshan Fan, Chaobo Feng, Shisheng He
Orthopaedics Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Disclosures
All authors listed meet the authorship criteria according to the latest guidelines of the
International Committee of Medical Journal Editors and are in agreement with the
manuscript. There was no any potential conflicts of interest among all authors and thanks
to all the authors for their efforts. The study did not receive any form of funding support.
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Introduction V-type Bichannel Endoscopy (VBE)
► Accommodate multiple instruments simultaneously► Full-time and real-time visualization► Extensive surgical view and operative space► Be qualified to conduct dorsal-side foraminoplasty
Main working channelDeputy working channel
Improvements of foraminoplasty
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Methods Cohort study
L5/S1 LDHPETD
THESSYS Group
VBE Group
Conventional strategy
PETD assisted by VBE
10:8
8:10
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Parameters VBE THESSYS P value
The duration of working cannula placement (mins) 19.08±2.30 24.90±4.71 <0.05*
Decompression time (mins) 44.18±5.70 47.46±5.96 0.17
Radiation exposure time (s) 28.00±4.70 40.50±5.73 <0.05*
Comparisons of surgical outcomes between VBE group and THESSYS group (Mean ± SD)
Surgical efficiency Radiation exposure
Results
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Groups Variables Preoperative 3 months 12 months
VBE VAS-low back 6.22±0.73 2.50±0.71* 1.28±0.46*
VAS-leg 6.94±1.11 2.83±0.79* 1.17±0.38*
ODI (%) 55.06±5.67 17.94±3.56* 12.28±3.27*
THESSYS VAS-low back 6.28±1.18 2.72±0.75* 1.33±0.49*
VAS-leg 6.78±1.06 2.78±0.65* 1.22±0.43*
ODI (%) 56.67±5.59 19.22±3.14* 12.44±1.98*
Pain relief and functional improvement in two groups (Mean ± SD)
*Stands for statistical significance compared with preoperative data
Results
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
V-type Bichannel Endoscopy (VBE) Group——Radiologic Improvement
Results
Improvements Safety: visualized operation & decreased
fluoroscopy Efficiency: accurate foraminoplasty & rapid
placement Standardization & Operability
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
DiscussionConventional strategies for foraminoplasty
Disadvantages► Low efficiency► Risk: neural injury► Inaccurate trajectory► Steep learning curve► Repeating fluoroscopy
Original Designed V-type Bichannel Endoscopy
V-type Bichannel Endoscopy (VBE) for Foraminoplasty
Summary
V-type Bichannel Endoscopy (VBE)
► Full-time and real-time visualized foraminoplasty —— Safety
► Just one incision —— Minimal invasion
► Two working channels —— Extensive surgical view and operative space
► Accommodate multiple instruments —— Efficiency and coordination
► Wedge-shaped tip —— Expand the indications, especially for dorsal-side foraminoplasty