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Войти в исследования Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy · 2025
Preoperative planning combining 3D reconstruction and body-surface meshing for percutaneous endoscopic lumbar discectomy in far lateral lumbar disk herniation.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Jiao Liang, Wang Shuang, Yang Xiao, Ma Jun-Xiong, Zheng Liang, Wang Hong, Xiang Liang-Bi, Yu Hai-Long, Chen Yu
Аннотация
BACKGROUND: Percutaneous endoscopic lumbar discectomy (PELD) is effective for far lateral lumbar disk herniation (FLLDH), requiring precise puncture. This study assessed 3D reconstruction combined with body-surface meshing for preoperative planning.
METHODS: This prospective randomized controlled trial enrolled 53 FLLDH patients (L4-5/L5-S1) from 2023 to 2024, who were randomized to Group A (n = 29; CT-based 3D-planning with surface grids) or Group B (n = 24; conventional X-ray planning). Outcomes included puncture time, operative time, fluoroscopy frequency, and Oswestry Dysfunction Index (ODI).
RESULTS: Baseline data were comparable (p > .05). Group A showed shorter puncture time (7.7 ± 2.1 min, 95% CI: 6.9-8.5 vs. 10.5 ± 3.8 min, 95% CI: 9.0-12.0), reduced operative time (48.7 ± 7.2 min, 95% CI: 46.2-51.2 vs. 55.2 ± 10.3 min, 95% CI: 51.0-59.4), and fewer fluoroscopy exposures (5.1 ± 1.9, 95% CI: 4.4-5.8 vs. 14.8 ± 3.9, 95% CI: 13.3-16.3; all p < .05). Both groups had improved ODI/VAS postoperatively (p < .05), with no intergroup clinical difference (p > .05).
CONCLUSIONS: 3D reconstruction enhances puncture precision and reduces intraoperative fluoroscopy reduction in FLLDH-PELD, with clinical outcomes comparable to those of conventional methods.
METHODS: This prospective randomized controlled trial enrolled 53 FLLDH patients (L4-5/L5-S1) from 2023 to 2024, who were randomized to Group A (n = 29; CT-based 3D-planning with surface grids) or Group B (n = 24; conventional X-ray planning). Outcomes included puncture time, operative time, fluoroscopy frequency, and Oswestry Dysfunction Index (ODI).
RESULTS: Baseline data were comparable (p > .05). Group A showed shorter puncture time (7.7 ± 2.1 min, 95% CI: 6.9-8.5 vs. 10.5 ± 3.8 min, 95% CI: 9.0-12.0), reduced operative time (48.7 ± 7.2 min, 95% CI: 46.2-51.2 vs. 55.2 ± 10.3 min, 95% CI: 51.0-59.4), and fewer fluoroscopy exposures (5.1 ± 1.9, 95% CI: 4.4-5.8 vs. 14.8 ± 3.9, 95% CI: 13.3-16.3; all p < .05). Both groups had improved ODI/VAS postoperatively (p < .05), with no intergroup clinical difference (p > .05).
CONCLUSIONS: 3D reconstruction enhances puncture precision and reduces intraoperative fluoroscopy reduction in FLLDH-PELD, with clinical outcomes comparable to those of conventional methods.