Full-time and Real-time Visualized Lumbar Foraminoplasty with V-type Bichannel Endoscopy (VBE)

Presenting author: Zhi Zhou

Co-authors: Zhi Zhou, Haijian Ni, Chuanfeng Wang, Yunshan Fan, Chaobo Feng, Shisheng He

Orthopaedics Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Disclosures

All authors listed meet the authorship criteria according to the latest guidelines of the

International Committee of Medical Journal Editors and are in agreement with the

manuscript. There was no any potential conflicts of interest among all authors and thanks

to all the authors for their efforts. The study did not receive any form of funding support.

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Introduction V-type Bichannel Endoscopy (VBE)

► Accommodate multiple instruments simultaneously► Full-time and real-time visualization► Extensive surgical view and operative space► Be qualified to conduct dorsal-side foraminoplasty

Main working channelDeputy working channel

Improvements of foraminoplasty

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Methods Cohort study

L5/S1 LDHPETD

THESSYS Group

VBE Group

Conventional strategy

PETD assisted by VBE

10:8

8:10

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Results V-type Bichannel Endoscopy (VBE) Group

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Parameters VBE THESSYS P value

The duration of working cannula placement (mins) 19.08±2.30 24.90±4.71 <0.05*

Decompression time (mins) 44.18±5.70 47.46±5.96 0.17

Radiation exposure time (s) 28.00±4.70 40.50±5.73 <0.05*

Comparisons of surgical outcomes between VBE group and THESSYS group (Mean ± SD)

Surgical efficiency Radiation exposure

Results

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Groups Variables Preoperative 3 months 12 months

VBE VAS-low back 6.22±0.73 2.50±0.71* 1.28±0.46*

VAS-leg 6.94±1.11 2.83±0.79* 1.17±0.38*

ODI (%) 55.06±5.67 17.94±3.56* 12.28±3.27*

THESSYS VAS-low back 6.28±1.18 2.72±0.75* 1.33±0.49*

VAS-leg 6.78±1.06 2.78±0.65* 1.22±0.43*

ODI (%) 56.67±5.59 19.22±3.14* 12.44±1.98*

Pain relief and functional improvement in two groups (Mean ± SD)

*Stands for statistical significance compared with preoperative data

Results

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

V-type Bichannel Endoscopy (VBE) Group——Radiologic Improvement

Results

Improvements Safety: visualized operation & decreased

fluoroscopy Efficiency: accurate foraminoplasty & rapid

placement Standardization & Operability

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

DiscussionConventional strategies for foraminoplasty

Disadvantages► Low efficiency► Risk: neural injury► Inaccurate trajectory► Steep learning curve► Repeating fluoroscopy

Original Designed V-type Bichannel Endoscopy

V-type Bichannel Endoscopy (VBE) for Foraminoplasty

Summary

V-type Bichannel Endoscopy (VBE)

► Full-time and real-time visualized foraminoplasty —— Safety

► Just one incision —— Minimal invasion

► Two working channels —— Extensive surgical view and operative space

► Accommodate multiple instruments —— Efficiency and coordination

► Wedge-shaped tip —— Expand the indications, especially for dorsal-side foraminoplasty