Integrated Optical and Magnetic Navigation for Simplified Percutaneous Transforaminal Endoscopic Lumbar Discectomy: A Novel Approach.

Abstract

Objective: This study aims to evaluate the clinical benefits of the integrated optical and magnetic surgical navigation system in assisting transforaminal endoscopic lumbar discectomy (TELD) for the treatment of lumbar disc herniation (LDH).

Methods: A retrospective analysis was conducted on patients who underwent TELD for LDH at our hospital from November 2022 to December 2023. Patients treated with the integrated optical and magnetic surgical navigation system were defined as the navigation-guided transforaminal endoscopic lumbar discectomy (Ng-TELD) group (30 cases), while those treated with the conventional X-ray fluoroscopy method were defined as the control group (31 cases). Record and compare baseline characteristics, surgical parameters, efficacy indicators, and adverse events between the two patient groups.

Results: The average follow-up duration for the 61 patients was 11.8 months. Postoperatively, both groups exhibited significant relief from back and leg pain, which continued to improve over time. At the final follow-up, patients' lumbar function and quality of life had significantly improved compared to preoperative levels (P < 0.05). The Ng-TELD group had significantly shorter total operation time (58.43±12.37 vs. 83.23 ± 25.90 min), catheter placement time (5.83 ± 1.09 vs. 15.94 ± 3.00 min), decompression time (47.17 ± 11.98 vs. 67.29 ± 24.23 min), and fewer intraoperative fluoroscopies (3.20 ± 1.45 vs. 16.58 ± 4.25) compared to the control group (P < 0.05). There were no significant differences between the groups in terms of efficacy evaluation indicators and hospital stay. At the final follow-up, the excellent and good rate of surgical outcomes assessed by the MacNab criteria was 98.4%, and the overall adverse event rate was 8.2%, with no statistically significant differences between the groups (P > 0.05).

Conclusion: This study demonstrates that the integrated optical and magnetic surgical navigation system can reduce the complexity of TELD, shorten operation time, and minimize radiation exposure for the surgeon, highlighting its promising clinical potential.