Full endoscopic lumbar interbody fusion (FELIF): technical note

Youn, Myung Soo; Shin, Jong Ki; Goh, Tae Sik; Lee, Jung Sub

doi:10.1007/s00586-018-5521-4

Cited by 67 publications

(44 citation statements)

References 11 publications

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“…can be used as a viable complement for spinal dysraphisms, degenerative and neoplastic spinal pathologies, including tethered cord, minimally invasive interbody fusion, and surgery for intradural tumors. [38][39][40] The major drawback of designing a single centre clinical trial with strict inclusion and exclusion criteria is that such research approach necessarily narrows down the number of potential candidates at time of patient selection. Additionally, if eligible patients prefer not to be enrolled and opt instead for what is considered to be the standard of care, then it is difficult to rule out the influence of a possible selection bias on the results obtained in both the treatment and control arms.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

et al. 2019

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Objective: Angled scopes allow 360° visualization, which makes percutaneous endoscopic techniques (percutaneous endoscopic lumbar discectomy, PELD) particularly attractive for sequestrectomies, which entail the removal of extruded lumbar disc fragments that have migrated caudally or cranially between the ligaments, foramina, and neural structures, while preserving the disc. Although many different PELD techniques are currently available, not all of them are suitable for sequestrectomies; furthermore, long-term follow-up data are unfortunately lacking. Methods: A pilot study was conducted on a cohort of 270 patients with lumbar radiculopathy undergoing minimally invasive spine surgery (PELD or microdiscectomy), of whom only 7 were eligible for endoscopic interlaminar sequestrectomy with disc preservation. The patients' baseline conditions and clinical outcomes were measured with the Oswestry Disability Index and a visual analogue scale. Long-term follow-up was conducted using satisfaction questionnaires that were based on the MacNab criteria and administered by medical/nursing personnel not involved in their primary surgical management. Results: EasyGo system was eventually used in 5 PELD cases. No dural tears, infections, or nerve root injuries were recorded in patients undergoing sequestrectomy. Surgical events, including blood loss and overall length of hospital stay, did not differ significantly among the 270 patients. In the group treated with endoscopic sequestrectomy, no recurrences or complications were noted during a follow-up of 3 years, and an excellent degree of satisfaction was reported. Conclusion: We provide OCEBM (Oxford Centre for Evidence-Based Medicine) level 3 evidence that interlaminar endoscopic sequestrectomy is a tailored and well-tolerated surgical option; nonetheless, a cost-effectiveness analysis assessing the interval until return to working activities and long-term benefits is warranted.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

et al. 2019

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“…The resulting smaller incision, minor trauma, and faster recovery have attracted the attention of spine surgeons. The surgical procedure includes a percutaneous puncture to locate the target segment, step‐by‐step expansion, placement of the operation channel for decompression, endplate preparation, implantation of the interbody cage, and fixation of a percutaneous pedicle screw. This surgical approach reduces the damage to the posterior spinal canal, making it less traumatic than traditional open surgery, with less bleeding, faster postoperative recovery, and a shorter hospital stay.…”

Section: Introductionmentioning

confidence: 99%

CT‐based Morphometric Analysis of Approach of Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion

Zhang

et al. 2019

Orthopaedic Surgery

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Objectives A radiographic study was designed to measure the relationship of the exiting nerve root and its surroundings to the corresponding intervertebral disc for percutaneous transforaminal endoscopic lumbar interbody fusion to better understand the regional anatomy and to improve clinical applications. Methods A retrospective study from January 2017 to October 2017 was conducted at Tianjin Hospital. CT images were obtained from patients presenting low back pain (110 patients), and analysis was performed bilaterally from L2‐3 to L5S1. In the rotating coronal plane we analyzed: the nerve root–dural sac distance at the superior and inferior margins of the disc (Js, Ji); the nerve root–pedicle distance at the medial, middle, and lateral borders of the pedicle (Pa, Pb, Pc); the pedicle width (W); and the safe working zone, defined as a trapezoid bounded by the inferior pedicle and the exiting nerve root (S). In the transverse plane, the nerve root‐articular process and the shortest distance for the nerve root‐articular process joint surface were analyzed at the superior and inferior margins of the disc (Gs, Gi), respectively. The groups were analyzed using ANOVA, and paired t‐tests were used to compare the left and right sides. Results From L2‐3 to L5S1, the distance of the nerve root to the dural sac was larger at the inferior margin of the disc. From L2‐3 to L5S1, each segment of the vertebral nerve root‐pedicle distance gradually decreased from medial to lateral. From L2‐3 to L5S1, the distance from the exiting nerve root to the middle and lateral margins of the pedicle gradually decreased, with L5S1 being the minimum. Some significant differences were observed between the left and right sides for L4‐5 and L5S1. The pedicle width of the vertebral body and the mean area for the safe working zone gradually increased from L2‐3 to L5S1. In the axial plane, the shortest distance between the nerve root and articular process joint surface at the inferior margin of the disc was greater than the distance for the nerve root to the articular process at the superior margin of the disc from L2‐3 to L5S1. There were no significant differences between the two sides. Conclusions It is more difficult to implant a cage with a width of 10 mm above the L3‐4 level. By removing part of the superior articular process, the safe working area can be expanded, and damage to the nerve or other structures can be avoided when implanting a cage.

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“…The cage was then introduced into the intervertebral disc space. Youn MS et al [13] reported a full endoscopic lumbar interbody fusion (FELIF). They used a beveled working cannula (13.7 mm outer diameter, 10.2 mm inner diameter) and an endoscope (10 mm outer diameter, 6 mm working channel, and 15° view angle) to carry out an endoscopic partial facetectomy of the superior articular process with su cient decompression and proper endplate preparation.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous endoscopic posterior lumbar interbody fusion(PEPLIF): technical note

He¹,

Feng²,

Ma³

et al. 2020

Preprint

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Background: Endoscopic lumbar interbody fusion is based on endoscopic lumbar discectomy, a well-established and widely used clinical procedure. Endoscopic lumbar interbody fusion has several key advantages over other types of procedures, including that it is minimally invasive, more precise, safer, and provides better visualization. Most surgeons use the transforaminal approach for this surgery. Here, we report the first percutaneous endoscopic posterior lumbar interbody fusion (PEPLIF). Methods: The authors introduce the PEPLIF technique with step by step instructions and describe key procedures in detail. Tips for controlling hemorrhages and avoiding complications during the procedure are presented. The authors also discuss the indications and advantages of applying the PEPLIF technique.Results: PEPLIF is a repeatable lumbar fusion technique.Conclusions: PEPLIF is a feasible and effective technique for the fusion of L4-5 and L5-S1 (especially L5-S1). All procedures are completed in full using endoscopy without replacing the cannula. The endoscopic view is similar to that of an open posterior lumbar interbody fusion, thus reducing the learning curve.

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Full endoscopic lumbar interbody fusion (FELIF): technical note

Abstract: FELIF is a safe and effective interbody fusion option to decompress the lumbar exiting nerve root and ventral side of dura directly with minimal invasive situation. These slides can be retrieved under Electronic Supplementary Material.

Cited by 67 publications

References 11 publications

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

CT‐based Morphometric Analysis of Approach of Percutaneous Transforaminal Endoscopic Lumbar Interbody Fusion

Percutaneous endoscopic posterior lumbar interbody fusion(PEPLIF): technical note

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