Clinical observation of fully visualized spinal endoscopic lumbar interbody fusion for the treatment of single-segment II lumbar spondylolisthesis

Abstract

OBJECTIVE: To retrospectively analyze the efficacy and safety of total visual spinal endoscopic lumbar interbody fusion (Endo-P/TLIF) for the treatment of single-segment II lumbar spondylolisthesis. METHODS: Twenty-one patients with single-segment II lumbar spondylolisthesis admitted to our department from January 2019 to September 2022 and meeting the inclusion criteria were analyzed, and the clinical data of patients with II spondylolisthesis were recorded, including 5 males and 16 females, with ages ranging from 37 to 78 years old, with an average of 60.81±1l.24 years old; the patients' preoperative and final follow-up times of the spinal intervertebral disc height (DH), lumbar lordosis (LL), and surgical segment lordosis (SLL) were measured preoperatively, at the time of the last follow-up; visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were recorded preoperatively, at 1 month postoperatively, at 6 months postoperatively, at 12 months postoperatively, and at the time of the last follow-up. Oswestnr disabilitv index (ODI) were recorded, as well as the operation time, hospitalization time, and postoperative complications during the follow-up period, the rate of spondylolisthesis (ROS) and lumbar fusion rate at the final follow-up time, and the rate of lumbar fusion by applying the Modified MacNab Scoring Scale at the final follow-up time. Modified MacNab scoring criteria were used for efficacy assessment. RESULTS: Compared with the preoperative period, the height of the intervertebral space was found to be significantly higher, and the anterior convexity angle of the lumbar spine and the anterior convexity angle of the operated segments were found to be significantly larger than before, and the differences were statistically significant (p< 0.05); the VAS scores and ODI indices of the patients at 1 month, 6 months, 12 months, and the time of the last follow-up were found to be significantly lower than that of the preoperative period, and the differences were statistically significant (p< 0.05); and the rate of lumbar spine slippage was found to be significantly higher than the preoperative period. The lumbar spine slippage rate was significantly improved compared with the preoperative rate (p < 0.05), and the lumbar spine fusion rate was 85.7%; the modified MacNab score measured at the time of the final follow-up was excellent in 80.9%; the incidence of postoperative complications was 9.5%, of which one case was asymptomatic cerebrospinal fluid leakage, which was restored to normal after treatment, and the other one case was neurological irritation, which was restored to good condition after dehydration, neurotrophic and hormonal treatments. The other case had symptoms of nerve heel irritation and recovered well after dehydration, neurotrophic and hormonal treatment. CONCLUSION:Endo-P/TLIF has good clinical efficacy in the treatment of single-segment II lumbar spondylolisthesis, which is conducive to promoting the patients' postoperative recovery, can effectively reduce the patients' lumbar pain and radicular pain of the lower limbs, and improve the lumbar spine dysfunction, which is a safe and effective surgical method.