Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion: Technique Note and Comparison of Early Outcomes with Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Spondylolisthesis
Received 23 December 2020
Accepted for publication 5 February 2021
Published 22 February 2021 Volume 2021:14 Pages 549—558
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Hao Zhang,* Chuanli Zhou,* Chao Wang, Kai Zhu, Qihao Tu, Meng Kong, Chong Zhao, Xuexiao Ma
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xuexiao Ma
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao, Shandong, 266000, People’s Republic of China
Tel +86 18661807895
Purpose: To compare the preliminary postoperative outcomes of percutaneous endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar spondylolisthesis.
Methods: Sixty-two patients with single-segment lumbar spondylolisthesis received Endo-TLIF and MIS-TLIF were enrolled in present study. Perioperative parameters, including operation time, estimated blood loss (EBL), interoperative fluoroscopy time, ambulation time and operative complications were recorded, respectively. The results of clinical metrics such as the Visual Analog Scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI) and the Japanese Orthopaedic Association (JOA) score were obtained, respectively. Postoperative fusion rates were assessed by clinical fusion and CT at 12-month after surgery.
Results: No significant differences were found in the demographic data between the two groups. Compared with MIS-TLIF group, Endo-TLIF group had similar operative time, less intraoperative blood loss and shorter ambulation time but longer duration of X-ray radiation. The postoperative VAS scores of back pain, ODI and JOA score were significantly improved comparing with the preoperative scores in two groups, but the Endo-TLIF group showed more significant improvement in the early follow-up (P < 0.05, respectively). There were no significant differences in terms of the interbody fusion rate between the two groups. Meanwhile, no serious postoperative complications were observed in the study.
Conclusion: Compared with MIS-TLIF, Endo-TLIF technique showed relatively faster recovery and better outcomes in terms of early curative effect, especially in 6 months after operation. However, intraoperative repeated fluoroscopy could result in highly cumulative radiation and longer operation time.
Keywords: percutaneous endoscopic transforaminal lumbar interbody fusion; Endo-TLIF, MIS-TLIF, lumbar spondylolisthesis, clinical outcome
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