Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: Technique Note and Comparison of Early Outcomes with Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spondylolisthesis

Abstract

Purpose To compare the preliminary postoperative outcomes of percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar spondylolisthesis. Methods Sixty-two patients with single-segment lumbar spondylolisthesis received Endo-TLIF and MIS-TLIF were enrolled in present study. Perioperative parameters, including operation time, estimated blood loss (EBL), interoperative fluoroscopy time, ambulation time and operative complications were recorded, respectively. The results of clinical metrics such as the Visual Analog Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) score were obtained, respectively. Postoperative fusion rates were assessed by clinical fusion and CT at 12-month after surgery. Results No significant differences were found in the demographic data between the two groups. Compared with MIS-TLIF group, Endo-TLIF group had similar operative time, less intraoperative blood loss and shorter ambulation time but longer duration of X-ray radiation. The postoperative VAS scores of back pain, ODI and JOA score were significantly improved comparing with the preoperative scores in two groups, but the Endo-TLIF group showed more significant improvement in the early follow-up (P < 0.05, respectively). There were no significant differences in terms of the interbody fusion rate between the two groups. Meanwhile, no serious postoperative complications were observed in the study. Conclusion Compared with MIS-TLIF, Endo-TLIF technique showed relatively faster recovery and better outcomes in terms of early curative effect, especially in 6 months after operation. However, intraoperative repeated fluoroscopy could result in highly cumulative radiation and longer operation time.

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

“… 7 Compared with the minimally invasive TILF (MIS-TLIF), Endo-TLIF demonstrated better outcomes and faster recovery time after operation, owing to less invasion. 13 , 27 In fact, the transforaminal approach must face the following challenges: exiting nerve roots injury and inadequately contralateral decompression, which have been determined by the anatomical structure. In a retrospective research, the TESSYS-ISEE technique was employed to remove the dorsal and ventral structures around the involved nerve root, which achieved 270-degree spinal canal decompression.…”

Comparison of Postoperative Outcomes Between Percutaneous Endoscopic Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spinal Stenosis

“…Despite these potential advantages, it remained unclear if PE-LIF had advantages for managing intervertebral space. Some scholars believe that with the endoscopic surgical technique, surgeons can handle the endplates under direct vision and determine adequate cartilage endplate removal ( 27 ). This may theoretically promote interbody fusion and reduce the risk of cage collapse.…”

“…Previous studies have mainly focused on nano-hydroxyapatite/polyamide-66 Cage (n-HA/PA66) and Polyetheretherketone (PEEK), which have been widely recognized. Recent studies have suggested that the titanium expandable cage can reduce nerve roots injury, restore lumbar lordosis, and achieve indirect decompression of the spinal canal and intervertebral foramen ( 22 , 27 ). However, the potential complications of bone endplate injury and pseudarthrosis could not be ignored during these procedures.…”

Percutaneous endoscopic versus minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative diseases: a meta-analysis.

“…To overcome MIS-TLIF shortcomings, percutaneous endoscopic TLIF (PE-TLIF) has been commonly used for patients with LDD [11][12][13]. PE-TLIF makes possible a complete endoscopic discectomy, spinal canal and foramina decompression, and interbody fusion via the endoscopic and working portal [14][15][16][17]. Although numerous earlier investigations explored the relative efficacies of PE-TLIF and MIS-TLIF in treating LDD [11][12][13][14][15][16][17][18], most of these studies were retrospective in nature.…”

“…PE-TLIF makes possible a complete endoscopic discectomy, spinal canal and foramina decompression, and interbody fusion via the endoscopic and working portal [14][15][16][17]. Although numerous earlier investigations explored the relative efficacies of PE-TLIF and MIS-TLIF in treating LDD [11][12][13][14][15][16][17][18], most of these studies were retrospective in nature. Since multiple factors can sway the outcomes of a retrospective investigation, and introduce unintentional bias, a meta-analysis is recommended to extensively evaluate relevant literature, reduce bias risk, and enhance the overall statistical power of the collective study outcomes.…”