Full Endoscopic Lumbar Transforaminal Interbody Fusion in DDD Lumbar Degenerative Disc Disease: A Latest Technique

Abstract

Background: Lumbar interbody fusion has long been used in the treatment of degenerative disc disease. Lumbar spinal interbody fusion surgery traditionally is an open surgical technique. Although lumbar spinal interbody fusions using endoscopy have been reported, the endoscope was used partially for the interbody fusion. We are reporting a case where lumbar interbody fusion with discectomy was entirely done through direct visualization with the endoscope.Methods: We report a case of a 55-year-old woman who underwent the transforaminal percutaneous fullendoscopic lumbar interbody fusion technique (FELTIF) under continuous and direct visualization at the L5-S1 level. To facilitate the interbody fusion, a foraminoplasty with complete resection of the superior articular process (SAP) and a partial pediculectomy of the S1 pedicle was performed. End plate sparing decortication techniques were used under direct video endoscopic visualization. The cage and bone graft insertion occurred through the endoscopic working cannula, thereby protecting the retracted traversing and exiting nerve roots at the surgical level. Posterior supplemental fixation with percutaneous pedicle screws was performed to complete the circumferential fusion.Result: The VAS leg score was reduced to 2 from preoperative score of 7 and the VAS back score reduced 3 from preoperative score of 9. Her neurogenic symptom score improved from 8 before surgery to 1 at the last follow-up. The fusion is assessed by plain radiographs in follow up.Conclusions: We concluded that the insertion of an interbody fusion cage device directly through an endoscopic working cannula was technically feasible. Future research should focus on examining the clinical outcomes of this technique.Level of evidence: 4.

Mikroszkópos és endoszkópos vizualizációval végzett, minimálisan invazív dekompressziós gerincműtétekkel kapcsolatos tapasztalataink

“…Az endoszkópos fejlődés egyértelműen kimutatható a dekompressziót célzó műtéteknél, de az utóbbi időben egyre gyakrabban számolnak be endoszkópos fúziós eljárásokról is [66,67]. Az endoszkópos gerincfúziós műtét a minimálisan invazív beavatkozások evolúciójában az egyik olyan mérföldkő, mely széles körű endoszkópos fúziós technikák kifejlesztéséhez vezethet [68,69].…”

Current Status and research hotspots in the field of full endoscopic spine surgery: A bibliometric analysis

“…Endoscopic advances have been clearly demonstrated in decompression surgery, and in recent times, endoscopic fusion procedures have been frequently reported (48,49). Full endoscopic spinal fusion surgery is a minimally invasive technique that is one of the landmarks in the advancement of spinal endoscopic technology; it has led to the development of comprehensive endoscopic spinal fusion procedures with more delicate and precise surgical techniques (50,51).…”

Combination of percutaneous endoscopic lumbar discectomy and platelet-rich plasma hydrogel injection for the treatment of lumbar disc herniation

“…Consequently, the minimally invasive technique draws increasing focus from surgeons and patients around the world. Percutaneous endoscopic lumbar discectomy (PELD) has been perceived to solve lumbar discectomy with the advantages such as soft tissue protection, less blood loss, and shorter hospital stays [ 2 , 6 , 7 ].…”