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KMID : 1040920210060010035
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Journal of Minimally Invasive Spine Surgery and Technique
2021 Volume.6 No. 1 p.35 ~ p.41
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Feasibility of Endoscopic Transforaminal Lumbar Interbody Fusion (eTLIF) Through the Posterior Paraspinal Approach: Technical Note and Preliminary Result
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Kim Hyeun-Sung
Raorane Harshavardhan Dilip
Wu Pang Hung
Heo Dong-Hwa
Yi Yeon-Jin
Yang Kyung-Hoon
Jang Il-Tae
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Abstract
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Objective: The implement of endoscopic spinal surgery has minimized the requirement of fusion procedures. However, certain patients still require fusion surgery such as instability. We performed a full-endoscopic transforaminal lumbar interbody fusion (eTLIF) through a conventional paraspinal approach.
Methods: eighteen consecutive patients with degenerative lumbar disease underwent eTLIF through paraspinal approach. Their clinical outcomes were evaluated with visual analog scale (VAS), Oswestry Disability Index (ODI) and the MacNab's criteria; radiological outcome measured with segmental lordosis (SLA), global lumbar lordosis (LLA), disc height (DH) on plain radiograph and percentage of potential fusion mass on CT scan at pre-operative, post-operative and final follow up period. intra operative and post-operative complications noted.
Results: Mean age was 63. 71 years and Mean follow-up periods was 7.78 months. In the X-ray result, mean SLA improved in pre-operative/post-operative/follow-up period 9.87±2.740/11.79±3.74 0/10.56±3.690 (p>0.01); mean LLA improved 37.1±7.040/39.2±7.130/35.7±7.250 (p>0.01). Mean DH improved from 8.97±1.49 mm/12.34±1.39 mm/11.44±1.98 mm(p<0.01). In the CT result, Average percentage of fusion mass was 42.61%. VAS was improved, 7.67/3.39/2.5 and ODI was improved, 74.9/34.56/27.76 by each preoperative/postoperative/final follow-up. In the clinical result, excellent was 5 cases and good was 13 cases.
Conclusion: eTLIF was competent and viable surgical procedure. The results were excellent in the form of endplate preservation, disc height restoration, minimal post-operative pain with early mobilization. The fusion volume occupies 40% to 50% of disc space is expected to give sufficient fusion.
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KEYWORD
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Endoscopic TLIF, Paraspinal approach, Feasibility, End plate preservation
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