Microendoscopy-Assisted Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: 5-Year Outcomes

Yang, Yang; Liu, Zhongyu; Zhang, Liangming; Pang, Mao; Chhantyal, Kishor; Wu, Wenbin; Chen, Zi-Hao; Luo, Chunxiao; Rong, Limin; Liu, Bin

doi:10.1016/j.wneu.2018.05.049

Cited by 30 publications

(32 citation statements)

References 21 publications

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“…conventional TLIF and open discectomy, PELD and MIS-TLIF are considered as good alternatives [8,10,11,[20][21][22][23][24][25]36]. In our department, as well PELD and MIS-TLIF are the most common choice of revision surgery for PELD recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…For all the patients in the two groups, off-bed activities could be performed on the second day after the surgery under the protection of waist support. The drain removal was conducted when the drainage uid for 24h was less than 30 ml [23] in MIS-TLIF group. The patients could return to non-manual work or school 2 weeks postoperatively and they were allowed to perform full activity 3 months after the surgery.…”

Section: Surgical Technique and Postoperative Managementmentioning

confidence: 99%

“…Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), rst reported by Foley in 2003 [19], is a lumbar fusion surgery for LDH which can decrease trauma to back muscles and damage to bony structures [20][21][22][23][24][25]. As mentioned above, PELD is an effective nonfusion surgery for LDH with the merit of minimal invasiveness as well.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy

Wang

2020

Preprint

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Background: Percutaneous endoscopic lumbar discectomy (PELD) has become a feasible alternative to the conventional open surgery for the treatment of lumbar disc herniation (LDH), but PELD is associated with a certain rate of recurrence. Therefore, a good choice of surgical approach for recurrent lumbar disc herniation (rLDH) is important. The purpose of this study was to compare the outcomes between PELD and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for revision surgery for the rLDH after primary PELD surgery.Methods: This study retrospectively assessed 46 patients who suffered from rLDH after PELD surgery in Peking University First Hospital from January 2015 to June 2019, and patients were divided into two groups, PELD group (n=24) and MIS-TLIF group (n=22), according to different revision surgical methods. Preoperative data, perioperative conditions, complications, recurrence condition, and clinical outcomes were compared between these two groups.Results: Compared with the MIS-TLIF group, the PELD group was associated with shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization, but higher recurrence rate. Complication rates were comparable between two groups. Both the two groups could provide patients with satisfactory clinical outcomes at the 12-month follow-up after revision surgery. Compared with MIS-TLIF, PELD was associated with visual Analog Scale (VAS) scores of back pain, and Oswestry disability index (ODI) at the 1-month follow-up, whereas this effect was equalized after 6 months postoperatively.Conclusions: Either PELD or MIS-TLIF surgery could provide satisfactory clinical outcomes for revision surgery for the rLDH after primary PELD. PELD brought advantages in shorter operative time, less intraoperative hemorrhage, and shorter post-operative hospitalization over MIS-TLIF, however, higher postoperative recurrence rate of PELD couldn’t be ignored. Surgeons must weigh advantages against disadvantages of these surgical methods and fully informed patients preoperatively.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Technique and Postoperative Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy

Wang

2020

Preprint

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“…Reducing the need for retraction of the nerve root and thecal sac, avoiding the need and risk to enter the abdominal cavity, preserving the anterior and posterior longitudinal ligaments, not devitalizing adjacent soft tissues, allowing the disc space to be accessed unilaterally, and preserving the contralateral facet complex are strategies that might enhance outcome. In addition, decreased blood loss, decreased postoperative pain, decreased hospital stay, lower infections rates, [24][25][26][27][28][29][30][31] and possibly decreased degeneration of the adjacent spinal levels would be expected to offer further refinement of therapeutic intent. 32 The stated goal of the MIS-TLIF approach is fusion of the painful segments; this has been reported to be equivalent to corresponding open procedures 26,[33][34][35][36][37][38] with fusion rates consistently over 90% when using rh-BMP-2 (InFUSE).…”

Section: Discussionmentioning

confidence: 99%

Transforaminal Lumbar Interbody Fusion With Viable Allograft: 75 Consecutive Cases at 12-Month Follow-up

2018

Int J Spine Surg

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Background: When conservative treatments fail to alleviate the discomfort of abnormal motion, spinal fusion has been shown to provide symptomatic treatment for spinal instability, stenosis, spondylolisthesis, and symptomatic degenerative disc disease. The trend and rates of fusion over the past few years have been dramatic in the United States. Accompanying that higher incidence has been the shifting from traditional open surgery to minimally invasive techniques to reduce scar tissue formation, extent of muscle stripping, and muscle retraction which all have been shown to adversely affect outcomes. Other reasons supporting the widespread transition to minimally invasive surgical (MIS) techniques include decreased postoperative pain, decreased intraoperative blood loss, shorter postoperative hospital stay, faster return to normal activity, and reduced reoperation rates. Spinal fusion procedures rely on a bony fusion substrate in addition to fixation hardware. While available grafting options include autogenous, allogeneic, and synthetic materials, recent interest in viable allograft material with living cells has drawn attention and attraction for incorporating a biologic basis for regenerative consideration. A recent viable allograft, complete with cellular and designated bone carrier (VIA Graft, Vivex Biomedical, Marietta, Georgia) has been developed. This study represents a retrospective review of a single-practice, single-surgeon evaluation of the product in 75 consecutive patients for fusion by computed tomography (CT) and radiographic evaluation at 12 months in conjunction with a MIS approach. Viable allograft was used to fill the peri-implant space, and central implant lumen was filled with a cancellous bone sponge soaked in perivertebral bone marrow. Posterolateral supplementation was attained with beta-tricalcium phosphate as a bulking agent.Methods: A retrospective review identified patients treated for both primary and revision surgery who received VIA Graft cellular bone matrix material in minimally invasive interbody fusion (MIS-TLIF) with a minimum of 12month follow up. The patient diagnoses included radiculopathy in all instances and varied collateral indications such as foraminal collapse, recurrent disc herniation, and spondylolisthesis to which pain and morbidity had been unresolved by conservative treatment. Adverse events including infection, revisions, and evidence of immune response were evaluated and patient comorbidities defined for the entire population of patients. Patient fusion status was assessed using thin slice CT by 2 independent radiologists separate from the surgeon. There were 75 consecutive adult patients with degenerative conditions of the lumbar spine who underwent MIS-TLIF surgery of which 40 (53%) were male and 35 (47%) were female. Mean age, height, and weight were 58 years, 170.18 cm (67 in), and 88.45 kg (195 lbs), respectively. The mean body mass index was 30. There were 16 patients (21%) who smoked and 12 (16%) with a history of diabetes. Independent blinded review of f...

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“…While these surgeries were initially limited to decompressive procedures, endoscopic-assisted fusion surgeries are now gaining increasing popularity [2][3][4][5][6][7][8][9]. These approaches offer the same benefit as traditional open approaches with reduced blood loss, decreased postoperative pain, and earlier discharge [2,10,11]. Nevertheless, the steep learning curve associated with these procedures has been well outlined in the literature and is likely one of the greatest barriers to more widespread acceptance of these 1 1 2 1 techniques.…”

Section: Introductionmentioning

confidence: 99%

The Value of a Synthetic Model-based Training Lab to Increase Proficiency with Endoscopic Approaches to the Spine

Basil

Brusko

Brooks

et al. 2020

Cureus

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Microendoscopy-Assisted Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion for Lumbar Degenerative Diseases: 5-Year Outcomes

Cited by 30 publications

References 21 publications

Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy

Comparison of Percutaneous Endoscopic Lumbar Discectomy and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Revision Surgery for the Recurrent Lumbar Disc Herniation After Percutaneous Endoscopic Lumbar Discectomy

Transforaminal Lumbar Interbody Fusion With Viable Allograft: 75 Consecutive Cases at 12-Month Follow-up

The Value of a Synthetic Model-based Training Lab to Increase Proficiency with Endoscopic Approaches to the Spine

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