Application of 3D visualization virtual surgery system in percutaneous transforaminal endoscopic discectomy

Abstract

Background

Percutaneous transforaminal endoscopic discectomy (PTED) is an effective minimally invasive technique for treating lumbar disc herniation (LDH). However, precise channel establishment remains challenging. A three-dimensional visualization virtual surgery system (3DVVSS) is increasingly used in specific surgeries, yet its value in PTED remains uncertain.

Objective

To investigate the application of a 3DVVSS combined with a self-made intervertebral foramen positioning puncture device (IFPPD) in PTED for the treatment of LDH.

Methods

This study enrolled 120 LDH patients who underwent PTED between January 2021 and February 2022. Patients were randomly assigned to 3DVVSS combined with the IFPPD group (V group), and the traditional freehand methods group (T group). Hospitalization days, number of puncture attempts, fluoroscopy time, operation time, visual analog scale (VAS), Oswestry disability index (ODI), and complications were analyzed.

Results

All patients completed follow-up without serious complications. Hospitalization days between the two groups were comparable (p > 0.05). However, the V group showed statistically significant advantages over the T group in puncture time, number of puncture attempts, fluoroscopy times, and operation time (p < 0.05). All patients exhibited significant improvements in VAS and ODI compared to those of preoperation (p < 0.05). Still, there was no significant difference in VAS and ODI between T and V groups (p > 0.05).

Conclusion

3DVVSS combined with IFPPD can significantly improve the successful puncture rate, and reduce the operation time and the fluoroscopy times, indicating its great potential in future clinical applications.