# A novel guiding device for puncture localization in percutaneous transforaminal endoscopic discectomy

## TL;DR

A new guiding device for a spinal surgery technique reduces the number of punctures and radiation exposure compared to traditional methods.

## Contribution

A novel puncture guiding device for percutaneous transforaminal endoscopic discectomy is developed and shown to improve accuracy and efficiency.

## Key findings

- The novel device reduced the number of punctures and fluoroscopies compared to traditional methods.
- Puncture localization and total surgical times were significantly shorter with the new device.
- Surgical efficacy was similar between the new device and traditional methods.

## Abstract

Conventional fluoroscopy-based positioning techniques for percutaneous transforaminal endoscopic discectomy (PTED) depend heavily on the operator’s spatial cognition and surgical expertise, typically necessitating multiple puncture attempts under iterative radiographic monitoring, which inherently involves substantial risks of iatrogenic injury and cumulative radiation exposure. This study aims to develop a simple and practical novel puncture guiding device for PTED and apply it in PTED surgery.

A novel guiding device for assisting puncture localization in PTED was developed. Patients scheduled for PTED were randomly divided into two groups: Group A and Group B, with 30 cases in each group. Group A used the novel guiding device for puncture localization in PTED, while Group B used the traditional fluoroscopic puncture method. The subsequent endoscopic surgical procedures were the same for both groups. The basic data of the patients, intraoperative puncture localization evaluation indicators (number of punctures, number of fluoroscopies, puncture localization time, surgical time), and surgical efficacy evaluation indicators were recorded and compared.

The number of punctures in Group A and Group B were 4.40 ± 0.89 and 7.93 ± 2.27, with Group A having significantly fewer punctures than Group B (P < 0.05). The number of fluoroscopies in the two groups were 13.03 ± 1.13 and 20.70 ± 3.34, respectively, with Group A having significantly fewer fluoroscopies than Group B (P < 0.05). The puncture localization time in the two groups were 34.57 ± 5.52 min and 43.00 ± 6.38 min, respectively, with Group A having a shorter puncture localization time than Group B (P < 0.05). The total surgical time in the two groups were 91.00 ± 10.70 min and 99.67 ± 10.08 min, respectively, with Group A having a shorter total surgical time than Group B (P < 0.05). There were no significant statistical differences in surgical efficacy evaluation indicators between the two groups (P > 0.05).

The novel guiding device has the advantages of being easy to use, fast and accurate in puncture, and having a high success rate. Compared with the traditional fluoroscopic puncture method, the novel guiding device can reduce the difficulty of puncture localization in PTED, improve puncture accuracy, and reduce the number of punctures, fluoroscopies, and puncture localization time.