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Tsai PC, Liu YC, Chang TK, Chen LP, Huang YC, Lian YS, Chien KT. The novel Kambin Torpedo full-endoscopic lumbar interbody fusion technique: a case series. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:417-428. [PMID: 37389696 DOI: 10.1007/s00586-023-07836-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/10/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE Full-endoscopic lumbar interbody fusion (FELIF) is a new-generation treatment for spondylolisthesis. However, owing to their unique characteristics, the two main endoscopic fusion trajectories, the trans-Kambin and posterolateral approaches, have important limitations. Herein, we aimed to introduce a new technique called Kambin Torpedo FELIF (KT-FELIF). METHODS The KT-FELIF technique is based on the trans-Kambin approach. It additionally completes ipsilateral total facetectomy and contralateral direct decompression. Thus, this novel technique combines the advantages of the trans-Kambin and posterolateral approaches. RESULTS We reported on the indications and technical steps of KT-FELIF and provided intraoperative and animated videos to clarify the procedure. Short-term follow-up based on 3-month postoperative computed tomography and plain films images taken at least 3 months after surgery showed adequate bony decompression, a large bone graft contact area, and good intervertebral trabecular bone growth without radiolucent lines between the graft, cage, and end plate. The clinical results, such as ipsilateral and contralateral visual analog scale and Oswestry disability index values, gradually improved at 1 and 3 months postoperatively. No complications were observed. CONCLUSIONS KT-FELIF is a promising FELIF technique for achieving bilateral direct decompression through a unilateral approach while accomplishing thorough discectomy and endplate preparation.
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Affiliation(s)
- Ping-Chi Tsai
- Department of Medical Education, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, Taipei City, 104217, Taiwan
| | - Yueh-Ching Liu
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan
| | - Ting-Kuo Chang
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan
| | - Lei-Po Chen
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan
| | - Yu-Ching Huang
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan
| | - Yan-Shiang Lian
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan
| | - Kai-Ting Chien
- Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City, 104217, Taiwan.
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Chen C, Liu C, Wu Z, Su J. How I do it? Uniportal full-endoscopic transforaminal lumbar interbody fusion with a complete reduction for L5 isthmic grade 2 spondylolisthesis. Acta Neurochir (Wien) 2023; 165:3969-3974. [PMID: 37946000 DOI: 10.1007/s00701-023-05886-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Endoscopic transforaminal lumbar interbody fusion (endo-TLIF) with bilateral percutaneous pedicle screw fixation is an emerging option for low-grade spondylolisthesis. However, uniportal full endo-TLIF with a complete reduction for high-grade spondylolisthesis is challenging. METHODS We attempted uniportal endo-TLIF for L5 isthmic grade 2 spondylolisthesis with a complete reduction, and have described the procedures, with a discussion of the indications, limitations, potential complications, and ways to avoid complications. CONCLUSION We had successfully completed a perfect reduction of L5 isthmic grade 2 spondylolisthesis via uniportal endo-TLIF with bilateral pedicle screw fixation. Uniportal endo-TLIF is suitable for isthmic grade 2 spondylolisthesis.
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Affiliation(s)
- Changxian Chen
- Department of Spinal Surgery, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian Province, China
| | - Chunhua Liu
- Department of Spinal Surgery, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian Province, China.
| | - Zhiqiang Wu
- Department of Spinal Surgery, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian Province, China
| | - Jinzhi Su
- Department of Spinal Surgery, Quanzhou Orthopedic-Traumatological Hospital, Quanzhou, Fujian Province, China
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Kim HS, Wu PH, Kim JY, Lee JH, Lee YJ, Kim DH, Lee JH, Jeon JB, Jang IT. Retrospective Case Control Study: Clinical and Computer Tomographic Fusion and Subsidence Evaluation for Single Level Uniportal Endoscopic Posterolateral Approach Transforaminal Lumbar Interbody Fusion Versus Microscopic Minimally Invasive Transforaminal Interbody Fusion. Global Spine J 2023; 13:304-315. [PMID: 35649510 PMCID: PMC9972267 DOI: 10.1177/2192568221994796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Retrospective comparative study. OBJECTIVE Assessment of difference in clinical and computer tomographic outcomes between the 2 cohorts. METHODS Computer tomographic evaluation by Bridwell's grade, Kim's stage, Kim's subsidence grade and clinical evaluation by VAS, ODI and McNab's criteria on both cohorts. RESULTS 33 levels of Endo-TLIF and 22 levels of TLIF were included, with a mean follow up of 14.3 (10-24) and 22.9 (13-30) months respectively. Both Endo-TLIF and TLIF achieved significant improvement of pain and ODI at post-operative 4 week, 3 months and at final follow up with VAS 4.39 ± 0.92, 5.27 ± 1.16 and 5.73 ± 1.21in Endo-TLIF and 4.55 ± 1.16, 5.05 ± 1.11 and 5.50 ± 1.20 in TLIF respectively and ODI at post-operative 1 week, 3 months and final follow up were 43.15 ± 6.57, 49.27 ± 8.24 and 51.73 ± 9.09 in Endo-TLIF and 41.73 ± 7.98, 46.18± 8.46 and 49.09 ± 8.98 in TLIF respectively, P < 0.05. Compared to TLIF, Endo-TLIF achieved better VAS with 0.727 ± 0.235 at 3 months and 0.727 ± 0.252 at final follow up and better ODI with 3.88 ± 1.50 at 3months and 3.42 ± 1.63 at final follow up, P < 0.05. At 6 months radiological evaluation comparison of the Endo-TLIF and TLIF showed significant with more favorable fusion rate in Endo-TLIF of -0.61 ± 0.12 at 6 months and -0.49 ± 0.12 at 1 year in Bridwell's grading and 0.70 ± 0.15 at 6 months and 0.56 ± 0.14 at 1 year in Kim's stage.There is less subsidence of 0.606 ± 0.18 at 6 months and -0.561 ± 0.20 at 1 year of Kim's subsidence grade, P < 0.05. CONCLUSION Application of single level uniportal endoscopic posterolateral lumbar interbody fusion achieved better clinical outcomes and fusion rate with less subsidence than microscopic minimally invasive transforaminal lumbar interbody fusion in mid-term evaluation for our cohorts of patients.
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Affiliation(s)
- Hyeun Sung Kim
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea,Hyeun Sung Kim, MD, PhD, Spine Surgery,
Nanoori Gangnam Hospital, Dogok-ro Gangnam-gu Seoul, Seoul 06278, Korea.
| | - Pang Hung Wu
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea,Orthopaedic Surgery, National University
Health System, JurongHealth Campus, Singapore, Singapore
| | - Ji Yeon Kim
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
| | - Jun Hyung Lee
- Department of Internal Medicine, Chosun
University School of Medicine, Gwangju, Korea
| | - Yeon Jin Lee
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
| | - Dae Hwan Kim
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
| | - Jun Hyung Lee
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
| | - Jun Bok Jeon
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
| | - Il-Tae Jang
- Spine Surgery, Nanoori Gangnam Hospital,
Seoul, Korea
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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. Diagnostics (Basel) 2022; 12:diagnostics12040793. [PMID: 35453844 PMCID: PMC9030158 DOI: 10.3390/diagnostics12040793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 12/10/2022] Open
Abstract
Objective: There is limited literature on repetitive postoperative MRI and clinical evaluation after Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression. Methods: Clinical visual analog scale, Oswestry Disability Index, McNab’s criteria evaluation and MRI evaluation of the axial cut spinal canal area of the upper end plate, mid disc and lower end plate were performed for patients who underwent single-level Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression. From the evaluation of the axial cut MRI, four types of patterns of remodeling were identified: type A: continuous expanded spinal canal, type B: restenosis with delayed expansion, type C: progressive expansion and type D: restenosis. Result: A total of 126 patients with single-level Uniportal Lumbar Endoscopic Unilateral Laminotomy for Bilateral Decompression were recruited with a minimum follow-up of 26 months. Thirty-six type A, fifty type B, thirty type C and ten type D patterns of spinal canal remodeling were observed. All four types of patterns of remodeling had statistically significant improvement in VAS at final follow-up compared to the preoperative state with type A (5.59 ± 1.58), B (5.58 ± 1.71), C (5.58 ± 1.71) and D (5.27 ± 1.68), p < 0.05. ODI was significantly improved at final follow-up with type A (49.19 ± 10.51), B (50.00 ± 11.29), C (45.60 ± 10.58) and D (45.60 ± 10.58), p < 0.05. A significant MRI axial cut increment of the spinal canal area was found at the upper endplate at postoperative day one and one year with type A (39.16 ± 22.73; 28.00 ± 42.57) mm2, B (47.42 ± 18.77; 42.38 ± 19.29) mm2, C (51.45 ± 18.16; 49.49 ± 18.41) mm2 and D (49.10 ± 23.05; 38.18 ± 18.94) mm2, respectively, p < 0.05. Similar significant increment was found at the mid-disc at postoperative day one, 6 months and one year with type A (55.16 ± 27.51; 37.23 ± 25.88; 44.86 ± 25.73) mm2, B (72.83 ± 23.87; 49.79 ± 21.93; 62.94 ± 24.43) mm2, C (66.85 ± 34.48; 54.92 ± 30.70; 64.33 ± 31.82) mm2 and D (71.65 ± 16.87; 41.55 ± 12.92; 49.83 ± 13.31) mm2 and the lower endplate at postoperative day one and one year with type A (49.89 ± 34.50; 41.04 ± 28.56) mm2, B (63.63 ± 23.70; 54.72 ± 24.29) mm2, C (58.50 ± 24.27; 55.32 ± 22.49) mm2 and D (81.43 ± 16.81; 58.40 ± 18.05) mm2 at postoperative day one and one year, respectively, p < 0.05. Conclusions: After full endoscopic lumbar decompression, despite achieving sufficient decompression immediately postoperatively, varying severity of asymptomatic restenosis was found in postoperative six months MRI without clinical significance. Further remodeling with a varying degree of increment of the spinal canal area occurs at postoperative one year with overall good clinical outcomes.
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Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note. Brain Sci 2021; 11:brainsci11091169. [PMID: 34573190 PMCID: PMC8470686 DOI: 10.3390/brainsci11091169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 01/14/2023] Open
Abstract
Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging angle, and operation time (inferior articular process resection time/total operation time) and clinical evaluation were made. Result: 48 cases of inside-out and 38 cases of outside-in cases were included. Compared to inside-out, the outside-in approach had significantly less operative time required to resect inferior articular process: 36.55 ± 10.37, and total operative time: 87.45 ± 20.14 min compared to 49.83 ± 23.97 and 102.56 ± 36.53 min, respectively, for the inside-out approach, p < 0.05. Compared to the preoperative state, both cohorts achieved significant improvement of VAS and ODI at post-operative 1 week, 3 months and at final follow up. Both cohorts achieved statistically significant increased disc height with 5.00 ± 2.87 mm, 5.49 ± 2.33 mm and statistically significant improvement in coronal wedge angle with 1.76 ± 1.63°, 3.24 ± 2.92° in the inside-out and outside-in approaches respectively. Conclusions: Complete removal of inferior articular process is the key part of endoscopic fusion with two methods that can be applied: an inside-out approach or an outside-in approach. Comparing both techniques, the outside-in approach has a shorter operative time required for inferior articular process resection and total length of operation with similar good clinical and radiological outcomes.
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Lara-Reyna J, Margetis K. Initial Experience With a Full Endoscopic Facet Fusion in Combination With Endoscopic Interbody Fusion. Cureus 2021; 13:e14327. [PMID: 33968535 PMCID: PMC8101511 DOI: 10.7759/cureus.14327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Facet fusion has been described in open and minimally invasive approaches to promote fusion. Our objective is to describe the technique of an endoscopic facet decortication and allograft placement as an adjunct to an interbody fusion. Methodology This was a descriptive analysis of patients who underwent endoscopic interbody fusion combined with facet fusion and percutaneous screw placement. General demographics, clinical presentation, length of stay, follow-up, and outcome were gathered. The technique involves endoscopic access to the Kambin’s triangle, discectomy/endplate preparation, expandable cage/allograft insertion, and percutaneous pedicle screw placement. A midline incision was performed, and the endoscope was advanced over the facet joints at the desired level. After removing the soft tissue with grasping forceps, cautery was used to disrupt the facet capsule. An articulating high-speed bur was used to drill inside and over the dorsal surface of the joint. Finally, allograft chips were placed through the endoscope cannula. Results From May 2019 to December 2019, four patients underwent endoscopic interbody fusion. All were female, with a mean age of 67.5 years (SD: 12.7). All had chronic low back pain and radiculopathy associated with Grade 1 spondylolisthesis. Two (50%) of the patients underwent two-level fusion. The median hospital stay was two days. Two (50%) reported improvement of both low back and radiculopathy symptoms. None of the patients had a significant complication or required reoperation in eight months’ mean follow-up. Conclusions Facet decortication and allograft placement are feasible using an endoscopic approach in conjunction with interbody fusion.
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Heo DH, Hong YH, Lee DC, Chung HJ, Park CK. Technique of Biportal Endoscopic Transforaminal Lumbar Interbody Fusion. Neurospine 2020; 17:S129-S137. [PMID: 32746526 PMCID: PMC7410385 DOI: 10.14245/ns.2040178.089] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
Biportal endoscopic transforaminal lumbar interbody fusion (TLIF) may have advantages of minimally invasive fusion surgery as well as those of endoscopic surgery. The purpose of this study was to present the biportal endoscopic TLIF technique along with video presentations and a review of the literature on this technique. Basically, the biportal endoscopic TLIF technique is similar to minimally invasive TLIF with a tubular retractor. There were 2 options in the biportal endoscopic TLIF procedures. The first was the insertion of one long TLIF cage and the other was the insertion of 2 short posterior lumbar interbody fusion (PLIF) cages. After the interbody fusion procedures, percutaneous pedicles screw fixation was performed. Biportal endoscopic TLIF achieved complete neural decompression through laminectomy and facetectomy like conventional TLIF. Endplate preparation was performed completely under a clear and magnified endoscopic view. It was also feasible to insert a large TLIF cage or 2 cages for PLIF without exiting nerve root injury. Biportal endoscopic TLIF might have the advantages of endoscopic surgery as well as minimally invasive fusion surgery. Direct neural decompression, endplate preparation under endoscopic guidance, and the insertion of a large TLIF cage or 2 PLIF cages may be the merits of biportal endoscopic lumbar fusion procedures.
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Affiliation(s)
- Dong Hwa Heo
- Department of Neurosurgery, Endoscopic Spine Surgery Center, Seoul Bumin Hospital, Seoul, Korea
| | - Young Ho Hong
- Department of Neurosurgery, Bundang Barunsesang Hospital, Seongnam, Korea
| | - Dong Chan Lee
- Department of Neurosurgery, Wiltse Memorial Hospital, Anyang, Korea
| | - Hun Jae Chung
- Department of Neurosurgery, Endoscopic Spine Surgery Center, Seoul Bumin Hospital, Seoul, Korea
| | - Choon Keun Park
- Department of Neurosurgery, Wiltse Memorial Hospital, Anyang, Korea
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Wu PH, Kim HS, Jang IT. A Narrative Review of Development of Full-Endoscopic Lumbar Spine Surgery. Neurospine 2020; 17:S20-S33. [PMID: 32746515 PMCID: PMC7410380 DOI: 10.14245/ns.2040116.058] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/28/2020] [Indexed: 12/15/2022] Open
Abstract
In the first phase of development of lumbar endoscopic spine surgery, the focus was on removal of soft disc material through the working corridor of Kambin’s triangle using transforaminal endoscopic lumbar discectomy. With the introduction of the interlaminar approach and increased interest from both industry and surgeons, there has been an exponential development of endoscopic surgical equipment and a corresponding expansion of endoscopic techniques. Endoscopic treatment strategies are applied to conditions ranging from contained prolapsed intervertebral discs to noncontained migrated herniated discs, hard calcified discs, spinal stenosis in the central or lateral recess and the foraminal and extraforaminal region, and other combinations of degenerative conditions requiring decompression or fusion surgery. The further expansion of endoscopic surgical management involving complicated spinal cases and the final quartet of trauma, infections, tumors, and possibly deformities could be the future stage of endoscopic spine surgery development. This article covers the full range of current treatment strategies and presents possible future developments of endoscopic spine surgery for the management of lumbar spinal conditions.
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Affiliation(s)
- Pang Hung Wu
- Nanoori Gangnam Hospital, Spine Surgery, Seoul, Korea.,National University Health System, JurongHealth Campus, Orthopaedic Surgery, Singapore
| | | | - Il-Tae Jang
- Nanoori Gangnam Hospital, Spine Surgery, Seoul, Korea
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Wu PH, Kim HS, Lee YJ, Kim DH, Lee JH, Jeon JB, Raorane HD, Jang IT. Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion with Endoscopic Disc Drilling Preparation Technique for Symptomatic Foraminal Stenosis Secondary to Severe Collapsed Disc Space: A Clinical and Computer Tomographic Study with Technical Note. Brain Sci 2020; 10:brainsci10060373. [PMID: 32549320 PMCID: PMC7348812 DOI: 10.3390/brainsci10060373] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Severe collapsed disc secondary to degenerative spinal conditions leads to significant foraminal stenosis. We hypothesized that uniportal posterolateral transforaminal lumbar interbody fusion with endoscopic disc drilling technique could be safely applied to the collapsed disc space to improve patients’ pain score, restore disc height, and correct the segmental angular parameters. Methods: We included patients who met the indication criteria for lumbar fusion and underwent uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion with pre-operative Computer Tomography mid disc height of less than or equal to 5 mm and MRI of Grade 3 Foraminal Stenosis. Visual analogue scale and computer tomography pre-operative and post-operative sagittal disc height in the anterior, middle and posterior part of the disc; sagittal focal segmental angle; mid coronal disc height and coronal wedge angles were evaluated. Results: 30 levels of Endo-TLIF were included, with a mean follow up of 12 months. The mean improvement in decreasing pain score was 2.5 ± 1.1, 3.2 ± 0.9 and 4.3 ± 1.0 at 1 week post operation, 3 months post operation and at final follow up, respectively, p < 0.05. There was significant increase in mid sagittal computer tomographic anterior, middle and posterior disc height of 6.99 ± 2.30, 6.28 ± 1.44, 5.12 ± 1.79 mm respectively, p < 0.05. CT mid coronal disc height showed an increase of 7.13 ± 1.90 mm, p < 0.05. There was a significant improvement in the CT coronal wedge angle of 2.35 ± 4.73 and the CT segmental focal sagittal angle of 1.98 ± 4.69, p < 0.05. Conclusion: Application of Uniportal Endoscopic Posterolateral Lumbar Interbody Fusion in patients with severe foraminal stenosis secondary to severe collapsed disc space significantly relieved patients’ pain and restored disc height without early subsidence or exiting nerve root dysesthesia in our cohort of patients.
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Affiliation(s)
- Pang Hung Wu
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
- National University Health System, JurongHealth Campus, Orthopaedic Surgery, Singapore 609606, Singapore
| | - Hyeun Sung Kim
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
- Correspondence:
| | - Yeon Jin Lee
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
| | - Dae Hwan Kim
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
| | - Jun Hyung Lee
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
| | - Jun Bok Jeon
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
| | - Harshavardhan Dilip Raorane
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
| | - Il-Tae Jang
- Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea; (P.H.W.); (Y.J.L.); (D.H.K.); (J.H.L.); (J.B.J.); (H.D.R.); (I.-T.J.)
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Kim HS, Wu PH, Lee YJ, Kim DH, Jang IT. Technical Considerations of Uniportal Endoscopic Posterolateral Lumbar Interbody Fusion: A Review of Its Early Clinical Results in Application in Adult Degenerative Scoliosis. World Neurosurg 2020; 145:682-692. [PMID: 32531438 DOI: 10.1016/j.wneu.2020.05.239] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Uniportal endoscopic posterolateral lumbar interbody fusion (Endo-TLIF) provides one of the least invasive forms of minimally invasive surgery, allowing large size cages which are commercially available for open and tubular microscopic transforaminal lumbar interbody fusion (TLIF) to be inserted through this approach. We studied the effect of such a technique on a series of patients with low-grade degenerative scoliosis. METHODS Endo-TLIF was applied to patients who had 10°-40° of degenerative adult scoliosis. Pre- and postoperative 1-week, 3-month, and final follow-up clinical status of visual analog scale, Oswestry Disability Index, perioperative complications, and Macnab criteria were collected. Roentgenogram to assess changes in Cobb angles was done. RESULTS There was statistically significant improvement of preoperative, 1-week postoperative, 3-month postoperative, and final follow-up mean of visual analog scale scores with 7.72 (5-10), 3.68 (3-6), 2.88 (2-4), and 1.96 (1-3), respectively, and with Oswestry Disability Index mean of 70.4 (52-86), 35.12 (26-56), 27.68 (24-38), and 24 (20-28), respectively (P < 0.05). In terms of Macnab criteria, 100% had good to excellent result. In terms of scoliosis measured by Cobb angle, there was statistically significant improvement. CONCLUSIONS Endo-TLIF is a safe and effective procedure in mild to moderate degenerative scoliosis with good early clinical results and improvement in coronal Cobb angle. It can be considered as an option if a short segment(s) fusion is planned for adult degenerative scoliosis.
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Affiliation(s)
- Hyeun Sung Kim
- Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea.
| | - Pang Hung Wu
- Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea; JurongHealth Campus, Orthopaedic Surgery, National University Health System, Singapore
| | - Yeon Jin Lee
- Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea
| | - Dae Hwan Kim
- Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea
| | - Il Tae Jang
- Department of Spine Surgery, Nanoori Gangnam Hospital, Seoul, Republic of South Korea
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