Korean J Pain.  2012 Apr;25(2):81-88. 10.3344/kjp.2012.25.2.81.

Evaluation of an Experimentally Designed Stereotactic Guidance System for Determining Needle Entry Point during Uniplanar Fluoroscopy-guided Intervention

Affiliations
  • 1Department of Biomedical Engineering, School of Medicine, Pusan National University, Yangsan, Korea.
  • 2Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea. pain@pusan.ac.kr

Abstract

BACKGROUND
In discography performed during percutaneous endoscopic lumbar discectomy (PELD) via the posterolateral approach, it is difficult to create a fluoroscopic tunnel view because a long needle is required for discography and the guide-wire used for consecutive PELD interrupts rotation of fluoroscope. A stereotactic system was designed to facilitate the determination of the needle entry point, and the feasibility of this system was evaluated during interventional spine procedures.
METHODS
A newly designed stereotactic guidance system underwent a field test application for PELD. Sixty patients who underwent single-level PELD at L4-L5 were randomly divided into conventional or stereotactic groups. PELD was performed via the posterolateral approach using the entry point on the skin determined by premeasured distance from the midline and angles according to preoperative magnetic resonance imaging (MRI) findings. Needle entry accuracy provided by the two groups was determined by comparing the distance and angle measured by postoperative computed tomography with those measured by preoperative MRI. The duration and radiation exposure for determining the entry point were measured in the groups.
RESULTS
The new stereotactic guidance system and the conventional method provided similarly accurate entry points for discography and consecutive PELD. However, the new stereotactic guidance system lowered the duration and radiation exposure for determining the entry point.
CONCLUSIONS
The new stereotactic guidance system under fluoroscopy provided a reliable needle entry point for discography and consecutive PELD. Furthermore, it reduced the duration and radiation exposure associated with determining needle entry.

Keyword

equipment design; fluoroscopy; needle; percutaneous discectomy; stereotactic technique

MeSH Terms

Diskectomy
Diskectomy, Percutaneous
Equipment Design
Fluoroscopy
Humans
Magnetic Resonance Imaging
Needles
Skin
Spine
Stereotaxic Techniques
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