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KMID : 1146020100030020115
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Journal of Critical Spine Cases
2010 Volume.3 No. 2 p.115 ~ p.119
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Full Endoscopic Transforaminal Lumbar Interbody Fusion Approach with Percutaneous Posterior Transpedicular Screw Fixation in a Case of Spondylolisthesis Grade I with L4-5 Central Stenosis
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Morgenstern Rudolf
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Abstract
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A case of a 79-year-old male patient complaining of low back pain for 1 year is reported. His symptoms were aggravated in the last 3 months. The magnetic resonance imaging showed a grade I spondylolisthesis at L4-5 level with severe central stenosis. In order to achieve maximal posterior opening of the L4-5 level we chose to fuse the L4-5 level with posterior stabilization in prone position with four percutaneous intrapedicular screws, bolt fixation for active distraction and anteroposterior reduction of the listhesis. The percutaneous posterolateral endoscopic approach with foraminoplasty and progressive tissue dilatation allowed a less aggressive surgery (with a small skin incision of 15 mm of length) for the transforaminal lumbar interbody fusion (TLIF) avoiding the excision of the superior facet, which would have otherwise been necessary in a posterolateral minimally invasive techniques approach. The patient was discharged after 24 hours of the intervention and three days after surgery the patient was pain-free (visual analogue scale= 0 and oswestry disability index=2). To our knowledge this is the first time that an endoscopic approach is used for a TLIF cage fusion instead of a minimally invasive techniques approach.
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KEYWORD
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Endoscopy, Foraminoplasty, Percutaneous approach, Percutaneous transforaminal lumbar interbody fusion, Transpedicular screws
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