An Innovative Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis with Degenerative Instability: a prospective cohort study

Abstract

Lumbar spinal stenosis (LSS) is most common lumbar degenerative diseases for people with low back pain. Endoscopic lumbar fusion technique was considered as a promising treatment for LSS with degenerative instability. The objective of this study was to compared the clinical effects for the treatment of Lumbar spinal stenosis (LSS) with degenerative instability between the innovative percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) technique and posterior lumbar interbody fusion (PLIF) technique. Between April 2019 and December 2019, 40 patients with single-segment LSS were prospectively included in our study. Visual Analogue Scale (VAS) on lumbar and leg pain (VAS-LBP, VAS-LP), Oswestry Disability Index (ODI), serum Creatine Kinase (CK), the maximal cross-sectional area of multifidus muscle (Max-CSA) and the peak intensity of Sulphur hexafluoride microbubble contrast agent (PI) around the surgical incision by contrast-enhanced ultrasonography were evaluated preoperatively, post-operatively and at regular follow-up. All patients were followed up. The VAS-LBP, VAS-LP, ODI after operation were improved significantly compared to these data before operation in all the patients (P < 0.05). The VAS-LBP at 1 weeks, 3 months after operation in PE-TLIF group were significantly lower than these in PLIF group (P < 0.05). The injury degree of multifidus muscle evaluated by MAX-CSA and PI was significantly less in PE-TLIF group after operation(P < 0.05). There was no significant difference on the complication rate between these two groups (P > 0.05). Our results presented PE-TLIF technique could obtain comparable effective outcomes as conventional PLIF for the treatment of LSS with degenerative instability. The Patients with PE-TLIF had less muscle injury, less pain and quicker postoperative rehabilitation. (A multicenter non-randomized controlled study for percutaneous endoscope transforaminal lumbar interbody fusion (PE-TLIF) and traditional open surgery for the treatment of degenerative diseases of the lumbar spine;2019/4/13; http://www.chictr.org.cn/showproj.aspx?proj=38002; ChiCTR1900022492)

The Influence of Percutaneous Endoscopy-Assisted Transforaminal Lumbar Decompression and Fusion in the Treatment of Single-Level Lumbar Spinal Stenosis on Multifidus Muscle from the Perspective of Traditional Chinese Medicine

“…In order to reduce the occurrence of adverse conditions, attention should be paid to the protection of lumbar multilobis muscle in the surgery, reduce unnecessary injury, and thus improve the surgical benefits and improve the prognostic effect. In recent years, under the concept of minimally invasive, the use of minimally invasive spinal technology can be fully and effectively decompression of lumbar spinal stenosis, and the use of minimally invasive lumbar decompression and fusion, to reduce the damage to polylobis muscle, and has achieved good results [6][7]. On this basis, the combination of spinal endoscopic techniques and the percutaneous spinal internal fixation technique produced a percutaneous endoscopic-assisted transforaminal lumbar decompression and fusion procedure.…”

Enhanced Recovery after an Innovative Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis: A Prospective Observational Study

“…The trial registration number is ChiCTR1900020679. The small parts of involved items have been published in a preprint [ 37 ].…”