Full-Endoscopic Posterior Lumbar Interbody Fusion with Epidural Anesthesia: Technical Note and Initial Clinical Experience with One-Year Follow-Up

Jiang, Chao; Yin, Si; Wei, Jiacheng; Zhao, Weigong; Wang, Xiaohui; Zhang, Yongyuan; Hao, Dingjun; Heng, Du

doi:10.2147/jpr.s338027

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…Complications including nerve root symptoms resulting from excessive intraoperative traction, incomplete decompression requiring open-access revision, and dural tear were reported in Groups A and B. In our study, patients underwent FE-PLIF reached a difinite fusion of 77.7% at 1-year follow-up, which was similar to previous study ( 32 ). The complications showed a decreasing trend with increased experience, suggesting that FE-PLIF is generally an effective, safe, and reliable method for decompression and stabilization.…”

Section: Discussionsupporting

confidence: 90%

Learning Curve and Initial Outcomes of Full-Endoscopic Posterior Lumbar Interbody Fusion

Tan

et al. 2022

Front. Surg.

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Study DesignThis was a retrospective cohort study.ObjectiveWe evaluated the feasibility, safety, and accuracy of full-endoscopic posterior lumbar interbody fusion (FE-PLIF) by assessing the learning curve and initial clinical outcomes.Summary of Background DataLow back pain is one of the crucial medical conditions worldwide. FE-PLIF has been reported to be a minimally invasive method to treat mechanical low back pain, but there lacks a thorough evaluation on this new technique.MethodsThe patients were divided into three groups in the order of operating date, implying that Group A consisted of the initial 12 cases, Group B the subsequent 12 cases, and Group C the last 12 cases. The data of patients were reviewed for gender, age, preoperative symptoms, satisfaction, as well as clinical outcomes demonstrated by visual analog scale (VAS). The operative time and intraoperative fluoroscopy were recorded to demonstrate the learning curve and the extent of radiographic exposure. Statistical significance was set at a p < 0.05 (two-sided).ResultsThe patients enrolled in this study were followed up at an average of 1.41 ± 0.24 years. Overall, patients were satisfied with the surgery. The average number of intraoperative fluoroscopy was 6.97 ± 0.74. A significant improvement was observed in the VAS of both lumbar pain and leg pain. The overall fusion rate was 77.7%. Complications were reported in two patients in Group A, one in Group B, and none in Group C. The average operative time showed a trend of gradual decline. The learning curve was characterized using a cubic regression analysis as y = –27.07x + 1.42x2–0.24x3 + 521.84 (R2 = 0.617, p = 0.000).ConclusionsFE-PLIF is an effective and safe method for treating low back pain caused by short-segmental degenerative diseases. The learning curve of this technique is steep at the initial stage but acceptable and shows great potential for improvement.

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Section: Discussionsupporting

confidence: 90%

Learning Curve and Initial Outcomes of Full-Endoscopic Posterior Lumbar Interbody Fusion

Tan

et al. 2022

Front. Surg.

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“…Compared with the traditional open surgery, minimally invasive surgery has less blood loss, not only a smaller incision, less invasion of soft tissue, but also may reduce the possibility of potential compartments after closing the incision. As a recent emerging spinal surgery technology, ELIF can meet the requirement of effective decompression and satisfactory fusion rate [18,19]. It is characterized by several incisions of about 1cm which greatly reduces the surgical trauma caused by paraspinal soft tissue dissection or traction and, unlike OLIF, avoids invading the super cial venous plexus and segmental arteries.…”

Section: Discussionmentioning

confidence: 99%

Hidden blood loss and its possible risk factors in full endoscopic lumbar interbody fusion

Zhao

et al. 2022

Preprint

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Objective Full endoscopic lumbar interbody fusion (ELIF) is a representative recent emerging minimally invasive operation, and its effectiveness has been continuously proved. This study aimed to evaluate the hidden blood loss in ELIF procedure and its possible risk factors. Methods The blood loss was calculated by Gross formula. Sex, age, BMI, hypertension, diabetes, ASA classification, fusion levels, surgical approach type(the count of trans-Kambin approach and interlaminar approach), surgery time, preoperative RBC, HGB, Hct, PT, INR, APTT, Fg, postoperative mean arterial pressure, postoperative heart rate, Intraoperative blood loss (IBL), patient blood volume were included to investigate the possible risk factors by correlation analysis and multiple linear regression between variables and hidden blood loss. Results 96 patients (23 males, 73 females) who underwent ELIF were retrospective analyzed in this study. The total blood loss was 303.56 (120.49, 518.43) ml(median [interquartile range]), of which the hidden blood loss was 240.11 (65.51, 460.31) ml, accounting for 79.10% of the total blood loss. Multiple linear regression analysis indicated that fusion levels(P = 0.002), age(P = 0.003), hypertension(P = 0.000), IBL(P = 0.012), PT(P = 0.016), preoperative HBG(P = 0.037) were the possible risk factor for HBL. Conclusion The fusion levels, younger age, hypertension, PT, preoperative HBG are possible independent risk factor of HBL during ELIF procedure. In clinic, we should pay attention to the possibility of large perioperative blood loss even in minimally invasive surgery.

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“…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). Under the same premise followed in the case of indications for lumbar fusion surgery, the recent clinical efficacy of this procedure has been satisfactory.…”

Section: Full Endoscopic Spinal Fusion Surgerymentioning

confidence: 99%

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

et al. 2022

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PurposeWe aimed to comprehensively analyze the current status, hotspots, and trends in full endoscopic spine surgery (FESS) research using bibliometric analysis and knowledge domain mapping.MethodsThe Web of Science database was used to screen FESS-related articles published between January 1, 1993 and June 10, 2022. The evaluation involved the following criteria: total number of articles; H-index; and contributions from countries/regions, institutions, journals, and authors.ResultsA total of 1,064 articles were included. Since 2016, there have been a significant number of publications in the field of FESS. The country/region contributing the largest number of articles was China (37.8%), followed by South Korea (24%), the United States (16.1%), Japan (5.7%), and Germany (5.1%). South Korea (35) had the highest H-index, followed by the United States (27), China (22), Japan (21), and Germany (20). World Neurosurgery (15.7%) published the largest number of FESS-related articles. However, among the top 10 most cited articles, six were published in Spine. The author who contributed the most was S.H. Lee (5.4%), and the largest number of contributions in this field originated from Wooridul Spine Hospital (South Korea; 6.1%). Notably, six of the 10 most published authors in this field were from South Korea. Of the top five productive institutions, three were from South Korea. The keywords with the strongest citation bursts in the field of FESS were “lumbar spine,” “discectomy,” “interlaminar,” “surgical technique,” “follow-up,” “excision,” “thoracic spine,” and “endoscopic surgery.” The 10 clusters generated in this study were: “endoscopic discectomy” (#0), “thoracic myelopathy” (#1), “recurrent lumbar disc herniation” (#2), “low back pain” (#3), “cervical vertebrae” (#4), “lumbar spinal stenosis” (#5), “transforaminal lumbar interbody fusion” (#6), “radiation exposure” (#7), “management” (#8), and “lumbar spine” (#9).ConclusionGlobal research on FESS is mostly concentrated in a few countries/regions and authors. South Korea has made the largest contribution to the field of FESS. Based on the most cited keyword bursts and clusters, the focus of FESS research was found to include its indications, management, and applications.

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Full-Endoscopic Posterior Lumbar Interbody Fusion with Epidural Anesthesia: Technical Note and Initial Clinical Experience with One-Year Follow-Up

Cited by 17 publications

References 34 publications

Learning Curve and Initial Outcomes of Full-Endoscopic Posterior Lumbar Interbody Fusion

Learning Curve and Initial Outcomes of Full-Endoscopic Posterior Lumbar Interbody Fusion

Hidden blood loss and its possible risk factors in full endoscopic lumbar interbody fusion

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

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