Percutaneous Bilateral Endoscopic Lumbar Interbody Fusion: Technical Note and Preliminary Results

Abstract

Objective. The purpose of this study was to investigate the feasibility and clinical efficacy of the percutaneous bilateral endoscopy technique (microendoscopic trans-Kambin’s triangle lumbar interbody fusion + percutaneous endoscopic transforaminal decompression of the lumbar spinal canal, ME-TKT-LIF+ PETD) in the treatment of lumbar degenerative diseases. Methods. From May 2016 to September 2018, 29 patients (16 males and 13 females) who suffered from neurologic symptoms due to degenerative lumbar spine disease and underwent percutaneous bilateral endoscopy technique were enrolled. A microendoscope was used for fusion, and a percutaneous endoscope was used for spinal canal decompression. These patients’ perioperative and clinical outcome-related parameters were collected and analyzed. Results. The mean intraoperative blood loss was 72.8 ± 40.6 ml, the operation time was 87.1 ± 10.1 min, the postoperative ambulatory time was 1.69 ± 1.0 days, the hospital stay was 2.6 ± 1.3 days, and the follow-up period was 22.34 ± 4.2 months. The visual analog scale (VAS) and the Oswestry disability index (ODI) were significantly improved at the early postoperative and last follow-up, respectively. According to the modified MacNab criteria, 11 (11/29) cases were rated as excellent, 15 (15/29) as good, and 3 (3/29) as fair, and the excellent and good rate was 89.7%. Twenty-eight (28/29) cases demonstrated solid fusion, and the fusion rate was 96.6%. Conclusion. The percutaneous bilateral endoscopy technique is safe and feasible in the treatment of lumbar degenerative diseases, with the advantage that more normal anatomical structures are preserved. It is an optional method of lumbar interbody fusion.

Unilateral biportal endoscopy vs. open decompression for lumbar epidural lipomatosis-cohort study using a prospective registry

“…Bilateral decompression is frequently required in patients with LEF complicated by severe lumbar spinal stenosis. However, the steep learning curve of single-channel spinal endoscopy and limited operating equipment consisting of a single rigid working cannula makes bilateral decompression difficult and high-risk ( 14 ). With the development of spinal endoscopic techniques, unilateral biportal endoscopy has been employed to treat severe lumbar spinal stenosis.…”

Decompression via unilateral biportal endoscopy for severe degenerative lumbar spinal stenosis: A comparative study with decompression via open discectomy

“…Direct posterior bilateral decompression is indicated for severe DLSS. However, the learning curve of percutaneous endoscopic transforaminal discectomy (PETD) is steep, and the operating equipment is limited by the rigid sleeve, which accounts for the difficulty and high risks associated with bilateral decompression (9). With the development of spinal endoscopy technology, UBE can be used to treat DLSS.…”