Application of Musculoskeletal Ultrasound Guidance in Lumbar Transforaminal Endoscopic Surgery for Puncture and Catheterization.

Abstract

BACKGROUND Foraminal puncture is a key step in foraminal endoscopic surgery, but the radiation dosage poses a clinical risk to patients. To reduce the radiation dosage, we investigated the feasibility and clinical effect of endoscopic transforaminal puncture through the use of the musculoskeletal ultrasound-guided lumbar percutaneous posterolateral approach. MATERIAL AND METHODS Retrospective data of 80 lumbar percutaneous posterolateral approach endoscopic surgery patients from March 2018 to June 2021 were analyzed. The clinical efficacy was assessed by visual analogue scale (VAS) and Oswestry disability index (ODI) during the follow-up. RESULTS Between the musculoskeletal ultrasound-guided group and the C-arm X-ray machine fluoroscopy group, the puncture time of the musculoskeletal ultrasound-guided group was significantly shorter than that of the C-arm X-ray machine fluoroscopy group (t=13.113, P=0.010). The radiation received in the ultrasound guidance group was significantly less than in the C-arm X-ray group. There was no difference in ODI values between the 2 groups before surgery (t=0.195, P=0.286), 3 months after surgery (t=0.235, P=0.092), and 1 year after surgery (t=0.168, P=0.173). There was no significant difference in VAS scores between the 2 groups before surgery (t=0.715, P=0.610), 3 months after surgery (t=0.367, P=0.192), and 1 year after surgery (t=0.496, P=0.390). CONCLUSIONS Our data demonstrate that musculoskeletal ultrasound can accurately guide the lumbar percutaneous posterolateral approach for endoscopic foraminal puncture, which can significantly reduce the puncture time and the amount of X-ray radiation.