Ultrasound guidance for transforaminal percutaneous endoscopic lumbar discectomy may prevent radiation exposure: A case report |
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Authors: | Ming-Bo Zhang Long-Tao Yan Shou-Peng Li Ying-Ying Li Peng Huang |
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Affiliation: | Ming-Bo Zhang, Shou-Peng Li, Ying-Ying Li, Department of Ultrasound, General Hospital of Chinese PLA, Beijing 100853, ChinaLong-Tao Yan, Department of Pain, China-Japan Friendship Hospital, Beijing 100029, ChinaPeng Huang, Department of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, China |
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Abstract: | BACKGROUND Percutaneous endoscopic lumbar discectomy(PELD) has become a mature and mainstream minimally invasive surgical technique for treating lumbar disc herniation(LDH). Repeated fluoroscopy, with more than 30 shots on average, is inevitable to ensure its accuracy and safety. However, exposure to X-rays may pose a threat to human health. We herein report a case of ultrasound(US)-assisted PELD in two levels of LDH to explore a new possibility that can reduce the radiation dose during puncture and cannulation in PELD.CASE SUMMARY A 38-year-old man with low back pain and left leg pain for more than 7 years came to our clinic, his symptoms had aggravated for 1 month, and he was diagnosed with L3-4 and L4-5 disc herniations. He received US-guided PELD with good results: His straight leg elevation increased from 40 to 90 degrees after PELD, and his visual analog scale(VAS) and Oswestry Disability Index scores both significantly decreased immediately and 6 mo after PELD. With the guidance of US, he received only two shots of fluoroscopy(fluoroscopic time: 4.4 s; radiation dose: 3.98 mGy). To our knowledge, this is the first case of US-guided puncture and cannulation of PELD for LDH at two levels.CONCLUSION US could be used to guide PELD and has the potential to largely reduce radiation than traditional X-ray guidance. |
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Keywords: | Ultrasound Endoscopic lumbar discectomy Lumbar disc herniation Radiation Guidance Case report |
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