Percutaneous Endoscopic Lumbar Interbody Fusion: Results Over 47 Months of Follow-Up

Abstract

Introduction This study aims to investigate the clinical-functional results of a new surgical technique, Percutaneous Endoscopic Lumbar Interbody Fusion (PELIF), in patients with a clinical diagnosis of low back or sciatic pain and segmental instability who were submitted to surgery using this technique assisted by the attending physician. Materials and methods Patients completed a consent form and were clinically and radiographically re-assessed by independent evaluators using the visual analog scale (VAS) for pain, the Oswestry Disability Index (ODI), and the SF-36 Quality of Life Score in the pre- and postoperative periods. Their medical records were also reviewed for surgical time, length of hospital stay, need for blood transfusion, return to work, and radiographic fusion evaluation. Results In the group of 19 patients with 33 levels operated, VAS and ODI decreased from 10.0 and 64% to 2.0 and 28%, respectively. The SF-36 showed significantly higher scores in 5 of its 7 domains at the end of the follow-up as compared to the preoperative period scores. Only 1 case of pseudoarthrosis was diagnosed radiographically. Conclusions Percutaneous Endoscopic Lumbar Interbody Fusion (PELIF) has been shown to be a safe and efficient technique for the treatment of patients with segmental instability associated with low back or sciatic pain. Level of Evidence VI; Therapeutic Study; Case Series.

Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion (PETLIF): Current Techniques, Clinical Outcomes, and Narrative Review

“…The mean age of our patients was higher than that of the cases included in the extracted papers (70.5 vs. 36.1 [ 22 ] to 65.02 [ 31 ]). The indication of lumbar interbody fusion in young patients is avoided in our facility due to the potential for permanent restrictions and loss of flexibility in the spine [ 40 ].…”

“…Indirect decompression was achieved by an expandable cage in the other non-PETLIF paper [ 28 ]. Another article did not perform direct decompression, but it was not a technique for obtaining indirect decompression such as expanding disc height [ 22 ] ( Table 1 ). In this regard, PETLIF is the only procedure that aims to bring indirect decompression using an oval dilator, which is very different from other endoscopic minimally invasive lumbar interbody fusion procedures [ 14 ].…”

“…(2) Sample sizes ranged from 7 [ 20 ] to 114 [ 21 ] cases, an average of 54.7 cases. (3) Mean age of included cases in the literature ranged from 36.1 [ 22 ] to 70.7 [ 23 ] years old. (4) Follow-up periods were 12 [ 24 ] to 24.7 [ 25 ] months.…”

“…(9) Postoperative hospital days ranged from 3.11 [ 29 ] to 8.87 [ 30 ] days. (10) Operation time differed among papers from 87.5 [ 31 ] to 355 [ 22 ] min. A shorter operation time in ELIF compared to other procedures was reported in one report [ 30 ] and longer [ 25 ] in two papers.…”

“…(7) In most cases, direct decompression was performed. In contrast, indirect decompression has been applied some cases in the transforaminal approach [14,22,27,28]. (8) PPS is installed after cage insertion in most of the manuscripts other than PETLIF [14] and PE-TLIF recently published [23].…”