Superior Articular Process Osteotomy Navigation (SapON) Technology in Percutaneous Endoscopic Lumbar Discectomy: A New Surgical Technology

Abstract

Background: This research aims to discuss the clinical application value of the superior articular process osteotomy navigation (SapON) technique in percutaneous endoscopic lumbar discectomy.Methods: Patients who underwent intervertebral foraminal endoscopic surgery for degenerative disease of the lumbar spine were collected and divided into two groups from March 2016 to May 2018. Group I: 69 patients were treated by the SapON technique. Group II: 53 patients were treated by Transforaminal Endoscopic Spine Surgery (TESS) technique. Fluoroscopy times, the time of establishment working channel, endoscopic operations, and entire operations in two groups were recorded. Patients' clinical curative effect was evaluated by visual analog scale (VAS) scores, Oswestry disability index(ODI), and MacNab standard at different time points, including before surgeries, one day, three months after surgeries, and the last follow-up time.Results: Operations were all successful both in groups I and II. Fluoroscopy times, establishing the working tunnels time, endoscopic operations time, and entire operations time and other indexes between the two groups were statistically significant. Patients’ low back, legs pain VAS scores, and ODI one day, three months after surgeries, and at the last follow-up in both two groups were significantly lower than those before operations with a statistical difference. The excellent rate in groups I and II were 98.55% and 96.23%. Complications were not observed in group I, while in group II, only one patient suffered the injury of the right L5 nerve root, and recovered after three months’ conservative treatment.Conclusion: The application of SapON in percutaneous endoscopic lumbar discectomy (PELD) has its advantages to popularize in clinical work, including operating simply and orderly, high safety, fewer complications, lower radiation exposure, and good clinical effects