Comparison of Radiation Exposure Among 3 Different Endoscopic Diskectomy Techniques for Lumbar Disk Herniation

Merter, Abdullah; Karaeminoğulları, Oğuz; Shibayama, Motohide

doi:10.1016/j.wneu.2020.04.079

Cited by 27 publications

(22 citation statements)

References 23 publications

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“…The articles were further screened by titles, abstracts, and full texts according to the specific inclusion and exclusion criteria. Ultimately, 59 articles were excluded, and the other 4 [ 16 – 19 ] were considered to be eligible for inclusion in this meta-analysis (184 patients, 95 in the PELD group and 89 in the UBE group), The flow chart of the literature search strategy is shown in Figure 1 . The baseline characteristics of the included studies are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [ 16 – 19 ] reported operation time between UBE and PELD (184 patients, 89 in the UBE group and 95 in the PELD group). Meta-analysis showed that the difference in operation time between the two groups was statistically significant (WMD = 35.36, 95% CI (4.67, 66.04), P = 0.02, heterogeneity: Tau 2 = 939.05, χ 2 = 137.66, df = 3 ( P < 0.00001), I 2 = 98%); PELD has a shorter operation time compared to UBE for ssLDH ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Zhu

Yao

Huang

et al. 2022

Applied Bionics and Biomechanics

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Objective. Spinal surgery is gradually moving toward minimally invasive surgery, but there is still some lack of knowledge about the Unilateral Biportal Endoscopic (UBE) technique that has been hotly debated in recent years. We performed this systematic review and meta-analysis to clarify whether UBE is superior to percutaneous endoscopic lumbar discectomy (PELD) for relieving short-term postoperative pain and promoting functional recovery. Methods. Computer searches of PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were performed to search for studies on UBE versus PELD for single-segment lumbar disc herniation (ssLDH) from the time of database construction to Mar. 2022, and two investigators independently performed literature screening and data extraction, and evaluation of the quality of the included studies was observed as operation time, complications, and visual analogue scale (VAS) at each preoperative and postoperative stage as well as Oswestry Disability Index (ODI), and meta-analysis was performed by applying the Review Manager 5.4 software. Results. Meta-analysis showed that PELD had shorter operation time ( MD = 35.36 , 95% CI (4.67, 66.04), P = 0.02 ) and had lower VAS of back pain at 3 days postoperatively ( MD = 0.62 , 95% CI (0.04, 1.19), P = 0.04 ) compared to the UBE. However, there was no statistical significance between the two groups in terms of complications ( MD = 2.53 , 95% CI (0.40, 16.11), P = 0.33 ), VAS of back pain at 30 days postoperatively ( MD = 0.05 , 95% CI (-0.19, 0.28), P = 0.70 ), VAS of leg pain at 3 days postoperatively ( MD = 0.21 , 95% CI (-0.20, 0.61), P = 0.33 ), VAS of leg pain at 30 days postoperatively ( MD = 0.09 , 95% CI (-0.29, 0.46), P = 0.65 ), and ODI at 30 days postoperatively ( MD = − 0.81 , 95% CI (-3.03, 1.41), P = 0.47 ). Conclusions. Current evidence suggests that both UBE and PELD are effective in relieving short-term postoperative pain and promoting functional recovery, and there is no difference in complications between them; UBE requires longer operation time, and PELD may be superior in relieving immediate postoperative pain. This trial is registered with PROSPERO ID: CRD42021287810.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Zhu

Yao

Huang

et al. 2022

Applied Bionics and Biomechanics

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“…The UBE technique has been widely used in the treatment of lumbar degenerative diseases, with less iatrogenic injury and faster recovery ( 15 , 16 ). The application of UBE in cervical spine was mainly in foraminoplasty ( 12 , 17 ); There is only one report on spinal canal decompression and the technical requirements are relatively high ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Bilateral Biportal Endoscopic Open-Door Laminoplasty With the Use of Suture Anchors: A Technical Report and Literature Review

Zhu

Wang²,

Cheng³

et al. 2022

Front. Surg.

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BackgroundUnilateral biportal endoscopy (UBE) is a newly developed technique for spine surgery. Owing to the convenience of nerve decompression and compatibility with open surgical instruments under endoscopic guidance, this technique has seen widespread global use. In this study, we first used modified UBE with suture anchor fixation for cervical laminoplasty in a 65-year-old female patient with good clinical outcomes.MethodsWe used bilateral biportal endoscopy (BBE) for cervical laminoplasty with suture anchor fixation in a patient with cervical stenosis. Under endoscopic guidance, a bilateral approach was used to make the gutter and lift the lamina door. After the lamina doors were opened, sutures were tied tightly using facia cannula and knot pusher. After confirming the solidarity of the open-door status, the drainage tube was inserted and the incisions were closed. The patient’s pre- and postoperative radiological and clinical results were evaluated.ResultsPostoperative Japanese Orthopaedic Association (JOA) and Neck Disability Index (NDI) scores were improved clinically, and cervical canal was decompressed radiologically.ConclusionsBBE laminoplasty combined with suture anchor fixation showed a favorable clinical and radiological result and appears to be a safe and effective technique for cervical stenosis.

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“…Since humans are exposed to passive radiation daily and that exposure compounds over time, reduced radiation exposure during surgical procedures is essential in order to further mitigate cancer, cataracts or other avoidable medical developments. Additionally while minimally invasive interventions have advantages over an open approach the need for imaging methods increases with decreasing invasiveness further adding to hospital personal exposure [5]. The FDA's center for Devices and Radiological Health launched an initiative in 2010 to reduce the unnecessary radiation exposure from medical imaging [6].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Intraoperative Fluoroscopic Radiation Emission Using ALARA Methods Versus Image-Enhancement Technology in Single-Position Lateral Lumbar Surgery

Braly¹,

Mason²,

Lange

et al. 2021

OPROJ

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Background: Expanded interest in minimally invasive spine techniques has led to increased reliance on intraoperative imaging to guide surgical decision making. Attempts to minimize the amount of radiation by using the dosage 'as low as reasonably achievable' (ALARA) has proven acceptable in decreasing the risk to the surgeons and staff to a certain extent, though the reciprocal nature of radiation reduction and image usability (quality) challenge further expansion of ALARA in this setting. Emerging technologies propose to reduce the radiation requirements even further without compromising image quality. In this study, radiation emission and fluoroscopy time were evaluated when image-enhancing technology was applied to minimally invasive single-position lumbar surgery to further our understanding of how imageenhancement technology performs in comparison to established ALARA protocols. Methods: This was a retrospective case-control study which in radiation emission and intra-operative fluoroscopy time was measured in patients undergoing lateral based, single-position surgery. From Oct 2018 through July 2019, 68 patients underwent one-or two-level single-position, lateral-based lumbar fusions by the same surgeon and operative team (including radiation technologist) at one of two hospitals. Both hospitals utilize an ALARA protocol in the operating rooms. One institution has acquired image-enhancing technology which aims to further reduce radiation emission and exposure while the other uses standard ALARA techniques. Intraoperative radiation data were retrospectively reviewed for comparison.Results: Image-enhancing technology allowed for further reduction of radiation emission from the fluoroscope by 36% when compared to the current low-dose ALARA protocols. Operative workflow features within the image-enhancing system allowed for a reduction of overall fluoroscopic time requirements by 34%, which aided in the overall 36% reduction in radiation emission. Conclusion:Emerging image-enhancement technology allows for further reduction of radiation emission in the operating room by 36% when compared to current, low-dose protocols established by ALARA.

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Comparison of Radiation Exposure Among 3 Different Endoscopic Diskectomy Techniques for Lumbar Disk Herniation

Cited by 27 publications

References 23 publications

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Short-Term Postoperative Pain and Function of Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Lumbar Discectomy for Single-Segment Lumbar Disc Herniation: A Systematic Review and Meta-analysis

Case Report: Bilateral Biportal Endoscopic Open-Door Laminoplasty With the Use of Suture Anchors: A Technical Report and Literature Review

A Comparison of Intraoperative Fluoroscopic Radiation Emission Using ALARA Methods Versus Image-Enhancement Technology in Single-Position Lateral Lumbar Surgery

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