Application Research On Mimics Virtual Surgery Design In L5/S1Transforaminal Endoscopic Discectomy

ObjectiveMimics software is applied to rebuild3D lumbar CT model. It guides the clinical operation by designing individual puncture indirection and stimulating the puncture and cathertering in L5/S1transforaminal endoscopic discectomy. By comparison with the empirical puncture method, the application of Mimics software in L5/S1transforaminal endoscopic discectomy and its feasibility, safety and superiority are evaluated in this paper. It provides a convenient, safe, effective puncture method in clinical diagnosis, which is expected to improve the success rate of L5/S1transforaminal endoscopic discectomy, shorten the operation time, reduce iatrogenic radiation, and improve the clinical curative effect.Methods40cases of patients with Protrusion of intervertebral disc L5/S1were included in this study, and all of the patients have received transforaminal endoscopic discectomy in spine surgery of Guangdong TCM Hospital. The patients aged from20to59years, with the average of37.7years. Among them,26cases were male and14cases were female. The patients were randomly divided into the control group and the experimental group with20cases in each group. The experimental group adopted Mimics software to rebuild3D spinal model. Puncture and cathertering in L5/S1transforaminal endoscopic discectomy were simulated in the computer to find the optimal direction, and then the patients were undergone transforaminal endoscopic discectomy with the help of X-ray machine. The control group adopted conventional empirical puncture method. The clinical data (approach establishment time, endoscopic operation time, X-ray perspective times, clinical curative effect and surgical complications) of the two groups was observed and collected, and SPSS19.0is used for statistical analysis.ResultsThere were no statistically significant differences (P>0.05) between the two groups of patients in age, gender, body height, boy weight, BMI, profession, classification of intervertebral disc, preoperative VAS score and JOA score. And the two groups were comparable. Surgeries in both of the two groups were complete, and no complications such as neurological damage, hematoma and infections occurred. Personalized puncture direction designed by Mimics software can effectively shorten the approach establishment time and endoscopic operation time, reduced the times of intraoperative X-ray perspective, and the results were statistically significant (P<0.05) compared with the control group. Short-term postoperative VAS score and JOA scores were significantly improved compared with the preoperative scores, and there were statistically significant differences (P<0.01). However, there were no statistically significant differences in short-term postoperative VAS score, JOA scores and modified Macnab efficacy evaluation index (P>0.05).ConclusionMimics simulation surgery design can intuitively judge the feasibility of L5/S1transforaminal endoscopic surgery. Preoperative designed puncture direction can effectively guide the clinical doctor performing cathetering on L5/S1. So, the successful rate of puncture is improved, the time for cathertering and endoscopic operation is reduced and the X-ray perspective times is also reduced. However, short-term surgical effects of the two groups of patients are not statistical difference. Mimics simulation surgery design does not improve the short-term surgical effects of L5/S1transforaminal endoscopic discectomy. In conclusion, clinical operation guided by Mimics software, which simulates cathertering and designs individual puncture direction, provides an effective method for individual puncture and cathertering in L5/S1transforaminal endoscopic discectomy, which is worthy of promotion and application.