Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation

Isaacs, Robert E.; Podichetty, Vinod K.; Santiago, Paul; Sandhu, Faheem A.; Spears, John; Kelly, Kevin R.; Rice, Laurie; Fessler, Richard G.

doi:10.3171/spi.2005.3.2.0098

Cited by 287 publications

(208 citation statements)

References 26 publications

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“…When compared to the open-PLF group that required average incision of 12 cm, a statistically equivalent fusion rate (97%) was achieved in the MIS-PLF group (vs. 100% in the open-PLF group). Table 3 summarizes the surgical times and intraoperative blood loss of MIS-PLF and Open-PLF in this study with comparative data from previously published TLIF reports [2,3,6,[10][11][12][13]. In previous TLIF studies, the MIS procedure tended to take more surgical time than open TLIF [3,6,10,11,13]; however, some authors reported a shorter surgical time [2,12].…”

Section: Discussionmentioning

confidence: 81%

“…In recent years, there have been several case series and comparative studies on minimally invasive lumbar spine fusions [1,[6][7][8][9][10][11][12][13][14]. In the present study, percutaneous pedicle screw-rod instrumentation was used for MIS-PLF.…”

Section: Discussionmentioning

confidence: 96%

“…Subsequently, Foley et al [4] introduced a percutaneous pedicle screw insertion and rod assembly system (CD Horizon Sextant, Medtronic, Memphis, TN, USA) for MIS-TLIF. After the introduction of the Sextant system, several authors reported their experience of using it for MIS-TLIF [6,[10][11][12][13]. However, the use of the Sextant system for lumbar posterolateral fusion (PLF) has been scarcely reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis

et al. 2011

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Introduction In order to minimize perioperative invasiveness and improve the patients' functional capacity of daily living, we have performed minimally invasive lumbar decompression and posterolateral fusion (MIS-PLF) with percutaneous pedicle screw fixation for degenerative spondylolisthesis with spinal stenosis. Although several minimally invasive fusion procedures have been reported, no study has yet demonstrated the efficacy of MIS-PLF in degenerative spondylolisthesis of the lumbar spine. This study prospectively compared the mid-term clinical outcome of MIS-PLF with those of conventional PLF (open-PLF) focusing on perioperative invasiveness and patients' functional capacity of daily living. Materials and methods A total of 80 patients received single-level PLF for lumbar degenerative spondylolisthesis with spinal stenosis. There were 43 cases of MIS-PLF and 37 cases of open-PLF. The surgical technique of MIS-PLF included making a main incision (4 cm), and neural decompression followed by percutaneous pedicle screwing and rod insertion. The posterolateral gutter including the medial transverse process was decorticated and iliac bone graft was performed. The parameters analyzed up to a 2-year period included the operation time, intra and postoperative blood loss, Oswestry-Disability Index (ODI), Roland-Morris Questionnaire (RMQ), the Japanese Orthopaedic Association score, and the visual analogue scale of low back pain. The fusion rate and complications were also reviewed. Results The average operation time was statistically equivalent between the two groups. The intraoperative blood loss was significantly less in the MIS-PLF group (181 ml) when compared to the open-PLF group (453 ml). The postoperative bleeding on day 1 was also less in the MIS-PLF group (210 ml) when compared to the open-PLF group (406 ml). The ODI and RMQ scores rapidly decreased during the initial postoperative 2 weeks in the MIS-PLF group, and consistently maintained lower values than those in the open-PLF group at 3, 6, 12, and 24 months postoperatively. The fusion rate was statistically equivalent between the two groups (98 vs. 100%), and no major complications occurred. Conclusion The MIS-PLF utilizing a percutaneous pedicle screw system is less invasive compared to conventional open-PLF. The reduction in postoperative pain led to an increase in activity of daily living (ADL), demonstrating rapid improvement of several functional parameters. This superiority in the MIS-PLF group was maintained until 2 years postoperatively, suggesting that less invasive PLF offers better mid-term results in terms of reducing low back pain and improving patients' functional capacity of daily living. The MIS-PLF utilizing percutaneous pedicle screw fixation serves as an alternative technique, eliminating the need for conventional open approach.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis

et al. 2011

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“…Since then, the minimally invasive techniques have been upgraded and used more extensively in the clinical practice. Isaacs et al [8] analyzed the results of 20 patients treated with posterior percutaneous screw fixation and minimally invasive cage interbody fusion, with a significant reduction of intra-operative blood loss, postoperative blood transfusions, and average length hospital stay versus conventional surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Ongoing technological progress led to the development of specific percutaneous surgical techniques to treat lumbar degenerative diseases [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

et al. 2011

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Intradiscal drug delivery system for the treatment of low back pain

Lee¹,

Lim²,

Park³

2009

J Biomedical Materials Res

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Possible solution to the long-term control of the low back pain (LBP) would be by using an injectable pain drug carrier that can be delivered locally. The drug can be released in a controlled manner. It is also allowed to inject repeatedly more drugs percutaneously with a minimal invasion. The main objective of this study was to develop such a drug delivery system (DDS) for long-term control of discogenic LBP. The DDS consists of in situ forming hydrogel matrix (Pluronic F127 plus sodium hyaluronate) containing microspheres (MS). The solid MS were used for long-term release of the drugs. Both hydrogel matrix and MS contained a model drug, bupivacaine base (BB). The phase transition (liquid at room temperature, gel at around body temperature) could be manipulated by changing the composition of the hydrogel. In vitro test showed that approximately 3% (w/w) of the BB loaded to MS were released during 42 days, demonstrating a good potential for sustained release of bupivacaine.

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Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation

Cited by 287 publications

References 26 publications

Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis

Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis

A minimally invasive posterior lumbar interbody fusion for degenerative lumbar spine instabilities

Intradiscal drug delivery system for the treatment of low back pain

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