Fig 1.
The schematic illustration of foraminoplasty with a single large trephine.
(A) Position diagram of the guide rod, the dilating cannula, the trephine and the tongue-shaped protective sheath. (B) Lateral position of the dilating cannula. (C) One-step foraminoplasty via a large trephine. (D) Anteroposterior diagram of the dilating cannula and foraminoplasty via a large trephine. (E) Removal of the nucleus pulposus.
Fig 2.
(A) The anteroposterior fluoroscopy after placing the puncture needle. (B) The lateral fluoroscopy after placing the puncture needle. (C) The fluoroscopy after placing the primary guide rod. (D) The fluoroscopy after placing the tongue-shaped protective sheath. (E) The anteroposterior fluoroscopy after placing the working cannula. (F) The lateral fluoroscopy after placing the working cannula.
Fig 3.
(A, B) Preoperative MRI showed the disc prolapse at the L4-L5 level. (C, D) The anteroposterior and lateral fluoroscopy of the working cannula in foraminoplasty with a single large trephine. (E, F) Postoperative MRI showed the complete removal of the protruded nucleus pulposus. (G) The bone parts of the articular process were removed in foraminoplasty. (H) The nerve roots were fully decompressed during the operation: the red arrow, nerve root; the blue star, the posterior longitudinal ligament; the yellow triangle, the nucleus pulposus.
Fig 4.
(A) Preoperative MRI showed the disc prolapse at the L4-L5 level. (B) Intraoperative anteroposterior and lateral fluoroscopy on the working cannula. (C) Postoperative MRI showed the complete removal of the protruded nucleus pulposus.
Table 1.
The patient demographic data.
Table 2.
Perioperative indicators.
Fig 5.
(A) VAS score of leg pain. (B) VAS score of low back pain. (C) ODI score. ns, no statistical difference; *P < 0.01 (significant difference among different time points of MS group); #P < 0.01 (significant difference among different time points of OS group).