Yawei Li1, Yuliang Dai1, Bing Wang2, Lei Li1, Pengzhi Li1, Jietao Xu1, Bin Jiang1, Guohua Lü1. 1. Department of Spinal Surgery, the Second Xiangya Hospital, Central South University, Changsha, China. 2. Department of Spinal Surgery, the Second Xiangya Hospital, Central South University, Changsha, China. Electronic address: xywb801@csu.edu.cn.
Abstract
OBJECTIVES: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been performed as a minimally invasive surgery for lumbar degenerative disease, but previous MIS-TLIF methods have shown limitations by their own characters. In this study, we developed a newly interbody fusion technique of full-endoscopic posterior lumbar interbody fusion (FE-PLIF) via an interlaminar approach, presented its preliminary clinical results in comparison with MIS-TLIF procedure. METHODS: This study retrospectively reviewed 52 patients who underwent FE-PLIF (n = 22) or MIS-TLIF (n = 30) surgery between October 2018 and February 2019. Patient demographics, intraoperative parameters, and perioperative complications were collated. Clinical and radiologic outcomes were evaluated at each follow-up for up to 12 months. RESULTS: FE-PLIF demonstrated a longer operation time, less blood loss, and shorter hospitalization duration than MIS-TLIF. The visual analog scale (VAS) score for leg pain in both groups and for back pain in FE-PLIF group significantly improved at 1 week, while the VAS score for back pain in MIS-TLIF group significantly improved at 3 months. No significant difference in the VAS and Oswestry disability index scores was found between the groups at 3 months and 12 months. Fusion rates of definite grades were not significantly different between the groups (73.3% vs. 70.0%, P > 0.05). All patients who suffered from cage subsidence or nonunion were asymptomatic and did not require revision surgery during the follow-up. CONCLUSIONS: The FE-PLIF interlaminar approach is a safe and effective interbody fusion technique with less surgical trauma and similar outcomes compared to MIS-TLIF. However, this technique still requires technical advancements to improve efficiency and reduce technical complexity.
OBJECTIVES: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been performed as a minimally invasive surgery for lumbar degenerative disease, but previous MIS-TLIF methods have shown limitations by their own characters. In this study, we developed a newly interbody fusion technique of full-endoscopic posterior lumbar interbody fusion (FE-PLIF) via an interlaminar approach, presented its preliminary clinical results in comparison with MIS-TLIF procedure. METHODS: This study retrospectively reviewed 52 patients who underwent FE-PLIF (n = 22) or MIS-TLIF (n = 30) surgery between October 2018 and February 2019. Patient demographics, intraoperative parameters, and perioperative complications were collated. Clinical and radiologic outcomes were evaluated at each follow-up for up to 12 months. RESULTS: FE-PLIF demonstrated a longer operation time, less blood loss, and shorter hospitalization duration than MIS-TLIF. The visual analog scale (VAS) score for leg pain in both groups and for back pain in FE-PLIF group significantly improved at 1 week, while the VAS score for back pain in MIS-TLIF group significantly improved at 3 months. No significant difference in the VAS and Oswestry disability index scores was found between the groups at 3 months and 12 months. Fusion rates of definite grades were not significantly different between the groups (73.3% vs. 70.0%, P > 0.05). All patients who suffered from cage subsidence or nonunion were asymptomatic and did not require revision surgery during the follow-up. CONCLUSIONS: The FE-PLIF interlaminar approach is a safe and effective interbody fusion technique with less surgical trauma and similar outcomes compared to MIS-TLIF. However, this technique still requires technical advancements to improve efficiency and reduce technical complexity.
Authors: Bryan Zheng; Elias Shaaya; Josh Feler; Owen P Leary; Matthew J Hagan; Ankush Bajaj; Jared S Fridley; Frank Hassel; Raymond Gardocki; Ricardo Casal Grau; Kai-Uwe Lewandrowski; Albert E Telfeian Journal: Biomed Res Int Date: 2022-03-19 Impact factor: 3.411