The Endoscopic Lumbar Interbody Fusion: A Narrative Review, and Future Perspective

Abstract

Lumbar interbody fusion stands as a preferred surgical solution for degenerative lumbar spine diseases. The procedure primarily aims to establish lumbar segment stability, directly addressing patient symptoms associated with spinal complications. Traditional open surgery, though effective, is linked with notable morbidities and extended recovery time. To mitigate these concerns, minimally invasive surgery (MIS) has garnered significant popularity, presenting an appealing alternative with numerous benefits such as reduced soft tissue trauma, decreased blood loss, and expedited recovery. Among MIS procedures, full endoscopic spinal surgery, characterized by its minimal invasiveness, holds the potential to further minimize morbidities while enhancing surgical outcomes. Endoscopic lumbar interbody fusion, a novel procedure within this paradigm, has gained attention for offering advantages comparable to those of minimally invasive transforaminal lumbar interbody fusion. However, the safety, efficacy, and associated surgical techniques and instrument design of this method continue to be subjects of ongoing debate. This paper critically reviews current evidence on the safety, efficacy, and advantages of endoscopic lumbar spinal interbody fusion, examining whether it could indeed supersede existing mainstream techniques.

Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery

“…The technique is based on the principle of indirect decompression and has several advantages, such as short operative time, minimal blood loss, and the ability to perform visualized preparation of the end plates. However, the disadvantages are the possibility of injuring the exiting nerve root and radiation exposure [ 69 ].…”

“…It has the advantage that it allows direct decompression of pathology with a minimally invasive technique [ 69 ]. FE-PLIF via the interlaminar approach is known to have outcomes compared to other popular minimally invasive techniques like MIS-TLIF with minimal surgical trauma [ 71 ].…”

Unveiling Evolution: Exploring Endoscopic Interbody Fusion Surgery in Minimally Invasive Spine Surgery — Editorial for the January 2024 Special Issue of JMISST

“…However, it is crucial to acknowledge that the success and efficacy of ELIF hinge upon several critical factors, including the patient's specific condition, the surgeon's expertise, and the precise application of surgical techniques [9,10]. Given the dynamic nature of medical progress, further refinements or novel developments in ELIF or analogous minimally invasive procedures have emerged since its inception.…”