Preoperative Simulation of the Trajectory for L5/S1 Percutaneous Endoscopic Transforaminal Discectomy: A Novel Approach for Decision-Making

Jiang, Ying-Kui; Wang, Rui; Chen, Chun Mei

doi:10.1016/j.wneu.2020.09.026

Cited by 3 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This indicates that the automatic image segmentation performance of the method proposed in this study is similar to that of medical professionals. Currently, the three-dimensional visualization model of the lumbar spine plays a crucial role in preoperative planning and path trajectory evaluation for lumbar surgery [ 9 , 27 ]. In this study, we have meticulously elucidated the anatomical structure adjacent to the lumbar intervertebral foramen and anterior to the lumbar spine, which will greatly facilitate preoperative planning of minimally invasive procedures in the lumbar region (including the MIS oblique approach and intervertebral foramen endoscopy, among others).…”

Section: Discussionmentioning

confidence: 99%

Deep Learning-Based Automated Magnetic Resonance Image Segmentation of the Lumbar Structure and Its Adjacent Structures at the L4/5 Level

Wang

Liu

et al. 2023

Bioengineering

View full text Add to dashboard Cite

(1) Background: This study aims to develop a deep learning model based on a 3D Deeplab V3+ network to automatically segment multiple structures from magnetic resonance (MR) images at the L4/5 level. (2) Methods: After data preprocessing, the modified 3D Deeplab V3+ network of the deep learning model was used for the automatic segmentation of multiple structures from MR images at the L4/5 level. We performed five-fold cross-validation to evaluate the performance of the deep learning model. Subsequently, the Dice Similarity Coefficient (DSC), precision, and recall were also used to assess the deep learning model’s performance. Pearson’s correlation coefficient analysis and the Wilcoxon signed-rank test were employed to compare the morphometric measurements of 3D reconstruction models generated by manual and automatic segmentation. (3) Results: The deep learning model obtained an overall average DSC of 0.886, an average precision of 0.899, and an average recall of 0.881 on the test sets. Furthermore, all morphometry-related measurements of 3D reconstruction models revealed no significant difference between ground truth and automatic segmentation. Strong linear relationships and correlations were also obtained in the morphometry-related measurements of 3D reconstruction models between ground truth and automated segmentation. (4) Conclusions: We found it feasible to perform automated segmentation of multiple structures from MR images, which would facilitate lumbar surgical evaluation by establishing 3D reconstruction models at the L4/5 level.

show abstract

Section: Discussionmentioning

confidence: 99%

Deep Learning-Based Automated Magnetic Resonance Image Segmentation of the Lumbar Structure and Its Adjacent Structures at the L4/5 Level

Wang

Liu

et al. 2023

Bioengineering

View full text Add to dashboard Cite

show abstract

“…Prolonged conservative treatment confines the adolescents to bed with significant ramifications, which has adverse physical and psychological effects 9 , 14 , 15 . Over the last two decades, more minimally invasive approaches have been introduced as alternatives for symptomatic ALDH 9 , 11 , 16 , 17 . However, evidence has failed to demonstrate which surgical option is best for lumbosacral junction ALDH with high iliac crest 12 , 18 .…”

Section: Discussionmentioning

confidence: 99%

“…However, such anatomical particularities can be overcome by using individualized targeted foraminoplasty 6 , 7 , 8 , 10 and by removing different parts of the S 1 SAP according to the site of herniated mass. Anatomically, foraminoplasty is highly advised, because the foraminal width is smallest at the lower lumbar levels and the nerve root lies ventrally 9 , 10 , 14 , 15 , 16 , 17 , 20 , 21 . Taking into account the published articles and our study 9 , we suggest that targeted foraminoplasty should be individualized for each situation.…”

Section: Discussionmentioning

confidence: 99%

“…Only with precise preoperative planning of the surgical approach can an optimal targeted trajectory be achieved. TELD can be sometimes impossible to perform because of the blockages of the surrounding anatomic structures, including a large L 5 transverse process, the sacral ala, high iliac crest, narrow foramen, and disc inclination resulting from lumbar lordosis, which can impede direct transforaminal access to the L 5 -S 1 neuroforamen with a straight, rigid spinal endoscope, and can increase the risk of nerve root injury and iatrogenic endplate injury 17 . However, such anatomical particularities can be overcome by using individualized targeted foraminoplasty [6][7][8]10 and by removing different parts of the S 1 SAP according to the site of herniated mass.…”

Section: Surgical Plan and Targeted Foraminoplastymentioning

confidence: 99%

See 1 more Smart Citation

Transforaminal Endoscopic Lumbar Discectomy for Lumbosacral Junction Adolescent Lumbar Disc Herniation with High Iliac Crests

Mao

Wang

Huang

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective To investigate the clinical results of transforaminal endoscopic lumbar discectomy for lumbosacral junction adolescent lumbar disc herniation with high iliac crest. Methods From February 2014 to September 2020, a retrospective analysis of 96 patients less than 21 years old with intervertebral disc herniation was carried out. We enrolled 44 patients diagnosed with lumbosacral junction disc herniation with high iliac crest who required transforaminal endoscopic lumbar discectomy. Pain in the back and the lower extremity was scored on Numeric Rating Scales (NRS) scores. Patient outcomes were graded as excellent, good, fair, and poor using modified MacNab criteria. The NRS scores before and after the operation were compared using the Wilcoxon two‐sample test. Results There were 30 male patients and 14 females. One patient underwent repeat surgery for an intervertebral disc pseudocyst. The NRS scores decreased significantly in both early and late follow‐up evaluations ( p < 0.05). At the last follow‐up, 42 patients (95.45%) had an excellent outcome, one patient (2.27%) had a good outcome, and one patient (2.27%) had a fair outcome. The overall success rate was 97.7%. Conclusion This study's data suggest that targeted individualized foraminoplasty can effectively overcome the lumbosacral anatomical obstacles, and transforaminal endoscopic lumbar discectomy is an effective and valid option for lumbosacral junction adolescent lumbar disc herniation with high iliac crest.

show abstract

Transforaminal lumbar endoscopic discectomy: should we abandon it for L5-S1 foraminal and extraforaminal lumbar disc herniations? A prospective non-randomised study and literature review

Kapetanakis,

Gkantsinikoudis

2024

British Journal of Neurosurgery

View full text Add to dashboard Cite

Preoperative Simulation of the Trajectory for L5/S1 Percutaneous Endoscopic Transforaminal Discectomy: A Novel Approach for Decision-Making

Cited by 3 publications

References 9 publications

Deep Learning-Based Automated Magnetic Resonance Image Segmentation of the Lumbar Structure and Its Adjacent Structures at the L4/5 Level

Deep Learning-Based Automated Magnetic Resonance Image Segmentation of the Lumbar Structure and Its Adjacent Structures at the L4/5 Level

Transforaminal Endoscopic Lumbar Discectomy for Lumbosacral Junction Adolescent Lumbar Disc Herniation with High Iliac Crests

Transforaminal lumbar endoscopic discectomy: should we abandon it for L5-S1 foraminal and extraforaminal lumbar disc herniations? A prospective non-randomised study and literature review

Contact Info

Product

Resources

About