Ultrasound guided percutaneous transforaminal endoscopic lumbar discectomy with no radiation: a case report

doi:10.3877/cma.j.issn.1674-6899.2019.02.012

Abstract

Abstract:

Objective

To explore the possibility of ultrasound guided percutaneous transforaminal endoscopic lumbar discectomy (PELD) with no radiation.

Methods

The lumbar transverse processes were used as the markers to locate the target level on longitudinal section. A hyperechoic zone on transverse section of lumbar ultrasound was used as the marker to puncture and cannulation of PELD, and the operation was completed.

Results

After operation, the symptoms were relieved obviously. Postoperative MRI showed that the solid tissue of nucleus pulposus in the herniated disc had been completely removed, and the nerve root had been completely released without complications.

Conclusions

This is the first case of zero radiation PELD guided by ultrasound in the world(Report of Novelty Search of Medical and Health Science and Technology No. 2019023; Novelty Search Station of Medical and Health Science and Technology, General Hospital of PLA; Novelty Search Time, March 18th, 2019). It has important value to further reduce the radiation dose of PELD during puncture and intubation under the guidance of ultrasound.

Key words: Ultrasound, Radiation, Endoscopic lumbar disectomy, Lumbar disc herniation

Mingbo Zhang, Peng Huang, Chengzhi Wu, Longtao Yan. Ultrasound guided percutaneous transforaminal endoscopic lumbar discectomy with no radiation: a case report[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(02): 111-114.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2019.02.012

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2019/V12/I02/111

Figures/Tables 4

References 14

1	Cong L, Zhu Y, Tu G. A meta-analysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation[J]. European Spine Journal, 2016, 25(1)：134-143.
2	Choi KC, Kim JS, Park CK. Percutaneous endoscopic lumbar discectomy as an alternative to open lumbar microdiscectomy for large lumbar disc herniation[J]. Pain Physician, 2016, 19(2)：291-300.
3	Eun SS, Lee SH, Sabal LA. Long-term follow-up results of percutaneous endoscopic lumbar discectomy[J]. Pain Physician, 2016, 19(8)：1161-1166.
4	Feng F, Xu Q, Yan F, et al. Comparison of 7 surgical interventions for lumbar disc herniation: a network meta-analysis[J]. Pain Physician, 2017, 20(6)：863-871.
5	黄良诚，陈锦旭，李宁，等．术中疼痛应答对腰椎经皮内镜手术安全的影响[J/CD]. 中华腔镜外科杂志(电子版), 2017, 10(3)：139-143.
6	Fan G, Gu X, Liu Y, et al. Lower learning difficulty and fluoroscopy reduction of transforaminal percutaneous endoscopic lumbar discectomy with an accurate preoperative location method[J]. Pain Physician, 2016, 19(8)：1123-1134.
7	Fan G, Han R, Gu X, et al. Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy[J]. International Orthopaedics, 2016, 41(2)：1-10.
8	Brenner DJ, Doll R, Goodhead DT, et al. Cancer risks attributable to low doses of ionizing radiation: assessing what we really know[J]. Proceedings of the National Academy of Sciences of the United States of America, 2003, 100(24)：13761-13766.
9	王丹莹，刘海元，史宏晖，等. 术中超声在妇产科手术中的应用[J/CD]. 中华腔镜外科杂志(电子版), 2017, 10(2): 118-121.
10	Liu YB, Wang Y, Chen ZQ, et al. Volume navigation with fusion of real-time ultrasound and ct images to guide posterolateral transforaminal puncture in percutaneous endoscopic lumbar discectomy[J]. Pain Physician, 2018, 21(3)：265-278.
11	Zhao Y, Bo X, Wang C, et al. Guided punctures with ultrasound volume navigation in percutaneous transforaminal endoscopic discectomy: a technical note[J]. World Neurosurgery, 2018, 119(1)：77-84.
12	Liu TJ, Shen F, Zhang C, et al. Real-time ultrasound-MRI fusion image virtual navigation for locating intraspinal tumour in a pregnant woman[J]. Eur Spine J, 2018, 27(2): 436-439.
13	张明博，黄鹏，王月香，等. 超声引导在椎间孔镜手术穿刺置管教学中的应用探索[J]. 中华医学教育杂志，2018, 38(5)：749-752.
14	Wu R, Liao X, Xia H. Radiation exposure to the surgeon during ultrasound-assisted transforaminal percutaneous endoscopic lumbar discectomy: a prospective study[J]. World Neurosurgery, 2017, 101(3): 658-665.

[1]	Hongbin Wang, Hongxia Zhang, Wen He, Lijuan Du, Linggang Cheng, Yukang Zhang, Meng Zhang. Ultrasound and contrast-enhanced ultrasound features of low-grade appendiceal mucinous tumor and appendiceal mucinous adenocarcinoma [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 865-871.
[2]	Yunjie Nong, Xiaogui Huang, Yulan Huang, Hengrong Nong. Clinical value of ultrasound in diagnosis of multiple microbial pulmonary infections [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 872-876.
[3]	Jiali Sun, Lin Jin, Cuiqin Shen, Qingqing Chen, Yanping Lin, Zhaojun Li, Dong Xu. Ultrasound-guided robot-assisted percutaneous puncture： an experimental study [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 884-889.
[4]	Yong Song, Dongxuan Li, Xiang Wang, Rui Li. Analysis of adverse reaction signals of three ultrasound contrast agents （Optison， Definity， and Lumason）using a data mining method [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 890-898.
[5]	Xiaoyan Zhang, Xining Wu, Yixiu Zhang, Zhenzhen Liu, Mengsu Xiao, Jianchu Li. Potential of humanistic literacy training in ultrasound department to enhance doctor-patient communication [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 899-903.
[6]	Yueying Hao, Yingxuan Mao, Yu Zhang, Jiaxu Wang, Linlin Han, Wenwen Kuang, Yao Meng, Xiuhua Yang. Ultrasound guided attenuation parameter for evaluating hepatic steatosis and predicting risk of cardiovascular disease [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 770-777.
[7]	Xuebing Shi, Yingdong Xie, Ni Xie, Chaoli Xu, Bin Yang, Guo Sun. Acoustic radiation force imaging for evaluating efficacy of radiotherapy in unresectable hepatocellular carcinoma patients with portal vein tumor thrombus [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 778-784.
[8]	Tingting Ye, Qingying Li, Hua Chen, Huaping Zeng, Shiya Wang, Min Wu, Juan Guo, Menghua Chen, Chanxian Tang, Fengting Liang, Huifang Wang. Consistency of full-stack smart pelvic floor ultrasound and manual method in obtaining and measuring the minimum levator hiatus plane [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 794-801.
[9]	Boran Wang, Chunmei Qiao, Chunge Li, Xin Wang, Xiaolei Wang. Value of contrast-enhanced ultrasound in assessing progression of subclinical synovitis in patients with rheumatoid arthritis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 802-808.
[10]	Zhenzhen Liu, Zhitong Ge, Ruina Zhao, Siting Peng, Yifan Dong, Xin Wang, Rui Zhang, Qingli Zhu, Jianchu Li, Xiao Yang. Teaching effectiveness of residents' case learning meetings in Department of Ultrasound Medicine of Peking Union Medical College Hospital [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 809-813.
[11]	Jiajia Wang, Yunyun Zhan, Fan Jiang, Biyun Sun, Yu Bi, Rubing Li, Mei Peng. Application of Peyton's four-step teaching method in standardized residency training program for ultrasound segmentation of cervical lymph nodes [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(08): 814-818.
[12]	Yijia Wang, Qing Zhou, Sheng Cao, Fangjie Yuan, Yan Zhou, Mei Zhang. Current status of quality control for image archiving and reporting of transthoracic echocardiography in China [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(07): 657-663.
[13]	Yi Zhou, Hongmei Zhang, Lixue Yin, Hao Yang, Pei Fu. Dynamic changing trends of ultrasound medicine quality control indicators in Sichuan Province [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(07): 664-670.
[14]	Xiaona Wang, Ning Zhang, Wei Song, ming Yang, Li Li, Hongyuan Xue. Analysis of current status of ultrasonic medical quality management and control in Hebei Province [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(07): 675-680.
[15]	Xiaowei Chang, Yu Cai, Zhiyong Zhao, Wei Zhang. Efficacy and safety analysis of high intensity focused ultrasound ablation combined with hepatic arterial chemoembolization in the treatment of primary hepatocellular carcinoma [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 56-59.

Please choose a citation manager

Content to export