Uniportal Endoscopic Lumbar Interbody Fusion

Abstract

The cause of radiculopathy is the compression of the nerve root which can be secondary to sliding of the vertebra and reduced disc height. In some patients, decompression alone does not resolve this problem. We describe the uniportal endoscopic transforaminal lumbar interbody fusion technique. Full-endocopic foraminotomy and discectomy are followed by cage implementation and percutaneous instrumentation. The goal of this surgical method is decompression of nerve roots, segment stabilization, disc height, and sagittal alignment restoration. Uniportal endoscopic facet sparing transforaminal transkambin lumbar interbody fusion is a good surgical option to treat degenerative disc disease, mechanical instability, and spondylolisthesis. This method shows favourable clinical outcomes in selected patients.

Clinical outcomes, complications and fusion rates in endoscopic assisted intraforaminal lumbar interbody fusion (iLIF) versus minimally invasive transforaminal lumbar interbody fusion (MI-TLIF): systematic review and meta-analysis

“…Besides the anesthetic technique and neuromonitoring, continuous spatial orientation of surgical instruments during the procedure is mandatory to avoid nerve root injury, either by direct trauma or excessive retraction. Pre-operative planning with magnetic resonance imaging (MRI) is crucial to assess the nerve root trajectory and eventual anatomic variations, mostly at L5S1 level where the dorsal root ganglion may be particularly endangered 10 , 14 . Proper training and previous experience in lumbar transforaminal endoscopic discectomy and decompression are advised.…”

“…Technological innovations in endoscopic spine surgery have widened its range of applications beyond lumbar disc herniations. Endoscopic treatment of central and lateral recess stenosis, as well as endoscopic assisted lumbar interbody fusion (LIF) for degenerative lumbar diseases, are increasingly common 9 , 10 .…”

“…Encouraged by the success of ED, endoscopic assisted intraforaminal LIF (iLIF) has been increasing its popularity. Even though several surgical techniques have been described, Kambin’s triangle approach through an intraforaminal facet sparing technique is the most usual and the one that has greater potential to reduce iatrogenic soft and bone tissue trauma 10 – 15 . Recent studies have shown promising results regarding reduced blood loss, decreased length of stay, clinical outcomes, complications and fusion 10 , 14 .…”

“…Even though several surgical techniques have been described, Kambin’s triangle approach through an intraforaminal facet sparing technique is the most usual and the one that has greater potential to reduce iatrogenic soft and bone tissue trauma 10 – 15 . Recent studies have shown promising results regarding reduced blood loss, decreased length of stay, clinical outcomes, complications and fusion 10 , 14 . However, the comparison between MI-TLIF and iLIF is sparse in the literature, and concerns about the safety and effective benefits of the endoscopic technique remain unanswered.…”

Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note

“…There is no direct decompression in KLIF and additional decompression is required if there is significant spinal stenosis. As the space in Kambin’s triangle is limited, there is a tendency to use a small width footprint cage for KLIF [ 8 , 9 , 10 , 11 ]. Facet sacrificing transforaminal lumbar interbody fusion is a good standard popular technique in the open, minimally invasive tubular approach and is recently becoming more popular in biportal endoscopic assisted fusion [ 12 , 13 , 14 , 15 ].…”