Mingbo Zhang1, Longtao Yan2, Shoupeng Li1, Yingying Li1, Peng Huang3. 1. Department of Ultrasound, General Hospital of Chinese PLA, Beijing, China. 2. Department of Pain, China-Japan Friendship Hospital, Beijing, China. 3. Department of Orthopedics, General Hospital of Chinese PLA, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China. harryhp@vip.sina.com.
Abstract
PURPOSE: The purpose of this study is to establish a new method to reduce the radiation dose during puncture and cannulation in percutaneous endoscopic lumbar discectomy (PELD). METHODS:Sixty patients with lumbar disk herniation undergoing PELD were prospectively enrolled and randomly divided into an ultrasound (US) guidance group and an X-ray guidance group. The puncture, cannulation, and total operation times; number of fluoroscopy shots; and radiation dose were recorded in both groups. The factors influencing the operation were analyzed. The clinical effect of PELD was evaluated using the straight leg elevation test, visual analog scale (VAS) and Oswestry disability index (ODI). The researchers who collected and analyzed the data were blinded to the group assignments. RESULTS: The puncture, cannulation and operation times in the US group were comparable to those in the X-ray group. The patients in the US group received 2.13 ± 0.35 fluoroscopy shots and a radiation dose of 5.34 ± 0.63 (mSV), which were significantly lower than the values in the X-ray group (7.57 shots ± 2.99 shots and 18.25 mSV ± 10.52 mSV) (P < 0.001). In the US group, the puncture time was significantly longer at the L5-S1 level, in patients with a BMI greater than 28 kg/m2 and in patients with a high iliac crest. The US and X-ray groups had comparable VAS and ODI scores 1 h and 3 months after PELD, and the VAS scores were significantly lower after PELD (all P < 0.001). No complications were observed in either group. CONCLUSIONS: US guidance is a new method that reduces the radiation dose required during puncture and cannulation in PELD. These slides can be retrieved under Electronic Supplementary Material.
RCT Entities:
PURPOSE: The purpose of this study is to establish a new method to reduce the radiation dose during puncture and cannulation in percutaneous endoscopic lumbar discectomy (PELD). METHODS: Sixty patients with lumbar disk herniation undergoing PELD were prospectively enrolled and randomly divided into an ultrasound (US) guidance group and an X-ray guidance group. The puncture, cannulation, and total operation times; number of fluoroscopy shots; and radiation dose were recorded in both groups. The factors influencing the operation were analyzed. The clinical effect of PELD was evaluated using the straight leg elevation test, visual analog scale (VAS) and Oswestry disability index (ODI). The researchers who collected and analyzed the data were blinded to the group assignments. RESULTS: The puncture, cannulation and operation times in the US group were comparable to those in the X-ray group. The patients in the US group received 2.13 ± 0.35 fluoroscopy shots and a radiation dose of 5.34 ± 0.63 (mSV), which were significantly lower than the values in the X-ray group (7.57 shots ± 2.99 shots and 18.25 mSV ± 10.52 mSV) (P < 0.001). In the US group, the puncture time was significantly longer at the L5-S1 level, in patients with a BMI greater than 28 kg/m2 and in patients with a high iliac crest. The US and X-ray groups had comparable VAS and ODI scores 1 h and 3 months after PELD, and the VAS scores were significantly lower after PELD (all P < 0.001). No complications were observed in either group. CONCLUSIONS: US guidance is a new method that reduces the radiation dose required during puncture and cannulation in PELD. These slides can be retrieved under Electronic Supplementary Material.
Entities:
Keywords:
Endoscopic lumbar discectomy; Lumbar disk herniation; Radiation; Ultrasound
Authors: Michael W Mariscalco; Takayuki Yamashita; Michael P Steinmetz; Ajit A Krishnaney; Isador H Lieberman; Thomas E Mroz Journal: Spine (Phila Pa 1976) Date: 2011-02-01 Impact factor: 3.468
Authors: John A Carrino; Jon D Lurie; Anna N A Tosteson; Tor D Tosteson; Eugene J Carragee; Jay Kaiser; Margaret R Grove; Emily Blood; Loretta H Pearson; James N Weinstein; Richard Herzog Journal: Radiology Date: 2008-10-27 Impact factor: 11.105
Authors: Joe Coyle; Sinead Kinsella; Siobhain McCarthy; Sebastian MacWilliams; Patrick McLaughlin; Joseph Eustace; Michael M Maher Journal: Abdom Imaging Date: 2012-08