Feasibility of Endoscopic Transforaminal Lumbar Interbody Fusion (eTLIF) Through the Posterior Paraspinal Approach: Technical Note and Preliminary Result

Abstract

The implement of endoscopic spinal surgery has minimized the requirement of fusion procedures. However, certain patients still require fusion surgery such as instability. We performed a full-endoscopic transforaminal lumbar interbody fusion (eTLIF) through a conventional paraspinal approach. Methods: eighteen consecutive patients with degenerative lumbar disease underwent eTLIF through paraspinal approach. Their clinical outcomes were evaluated with visual analog scale (VAS), Oswestry Disability Index (ODI) and the MacNab's criteria; radiological outcome measured with segmental lordosis (SLA), global lumbar lordosis (LLA), disc height (DH) on plain radiograph and percentage of potential fusion mass on CT scan at pre-operative, post-operative and final follow up period. intra operative and post-operative complications noted. Results: Mean age was 63. 71 years and Mean follow-up periods was 7.78 months. In the X-ray result, mean SLA improved in pre-operative/post-operative/ followup period 9.87±2.740/11.79±3.74 0/10.56±3.690 (p>0.01); mean LLA improved 37.1±7.040/ 39.2±7.130/35.7±7.250 (p>0.01). Mean DH improved from 8.97±1.49 mm/12.34±1.39 mm/11.44 ±1.98 mm (p<0.01). In the CT result, Average percentage of fusion mass was 42.61%. VAS was improved, 7.67/3.39/2.5 and ODI was improved, 74.9/34.56/27.76 by each preoperative/postoperative/final follow-up. In the clinical result, excellent was 5 cases and good was 13 cases. Conclusion: eTLIF was competent and viable surgical procedure. The results were excellent in the form of endplate preservation, disc height restoration, minimal post-operative pain with early mobilization. The fusion volume occupies 40% to 50% of disc space is expected to give sufficient fusion.

Unilateral biportal endoscopic versus microscopic transforaminal lumbar interbody fusion for lumbar degenerative disease: a retrospective study

“…In contrast, Biportal endoscopic surgery allows surgeons to utilize both hands by employing separate endoscopic and working portals. This separation facilitates clear visualization during cage insertion procedures, minimizing the likelihood of complications [33].…”

Prospective Cohort Study with a 2-Year Follow-up of Clinical Results, Fusion Rate, and Muscle Bulk for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion

“…EPTLIF is an alternative posterolateral approach to the traditional Trans-Kambin approach in uniportal endoscopic fusion and was used in this cohort study. It was previously described by Kim et al [ 12 , 13 , 18 ] and Wu et al [ 14 , 19 ]. Surgery was performed on a Wilson Frame over a radiolucent table, and the patient was under general anesthesia.…”

Remodeling Pattern of Spinal Canal after Full Endoscopic Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression: One Year Repetitive MRI and Clinical Follow-Up Evaluation

“…In terms of complication management, there was no complication in the type A cohort. In the type B cohort, there were three dura tears, which were treated with the patch blocking repair technique without sequelae [19]; three facet cysts were treated conservatively, and there was one case of instability, which required endoscopic transforaminal lumbar interbody fusion (ETLIF) one year after index surgery [20][21][22]. In the type C cohort, there were two cases of dura tear, which were repaired with patch blocking technique without sequelae and one case of instability, which required ETLIF one year after index surgery.…”