• Guoxin Fan, Chuanfeng Wang, Xin Gu, Hailong Zhang, and Shisheng He.
• Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
• World Neurosurg. 2017 Jul 1; 103: 899-905.e4.

BackgroundPosterolateral endoscopic trasforaminal discectomy (PELD) requires an ideal percutaneous puncture to place the working channel for endoscopic discectomy. The conventional blinded puncture relies on the surgeon's experience and repeated fluoroscopy, which may increase radiation exposure. This study aimed to introduce isocentric navigation to plan trajectory and guide punctures in PELD.MethodsTechnical note and clinical outcomes of patients undergoing PELD with isocentric navigation were recorded in this report.ResultsFour patients (3 female, 1 male) were included in this study. Age ranged from 21 to 67 years, and the body mass index ranged from 18.71 to 23.15 kg/m2. All of the included patients received just one puncture, and the radiation exposure time ranged from 15 to 40 seconds. The operation time ranged from 58 to 75 minutes, and no significant complications were observed. All patients reported significant pain relief and improved surgical outcomes, as assessed by the Oswestry Disability Index and Macnab criteria.ConclusionsIsocentric navigation is feasible in planning the trajectory and guiding the punctures in PELD and could be considered as a potential practical tool to facilitate surgery.Copyright © 2017 Elsevier Inc. All rights reserved.

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