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. 2022 Apr 7;23(1):329.
doi: 10.1186/s12891-022-05287-9.

Comparison of percutaneous endoscopic and open posterior lumbar interbody fusion for the treatment of single-segmental lumbar degenerative diseases

Li-Ming He  1 , Kuo-Tai Chen  2 , Chien-Min Chen  3   4   5 , Qiang Chang  1 , Lin Sun  1 , Yan-Nan Zhang  1 , Jian-Jun Chang  1 , Hao-Yu Feng  6
Affiliations

Comparison of percutaneous endoscopic and open posterior lumbar interbody fusion for the treatment of single-segmental lumbar degenerative diseases

Li-Ming He et al. BMC Musculoskelet Disord. .

Abstract

Background: Endoscopic lumbar interbody fusion has become an emerging technique. Some researchers have reported the technique of percutaneous endoscopic transforaminal lumbar interbody fusion. We propose percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) as an alternative approach. The purpose of this study was to assess the clinical efficacy of PE-PLIF by comparing percutaneous endoscopic and open posterior lumbar interbody fusion (PLIF).

Methods: Thirty patients were enrolled in each group. Demographic data, perioperative data, and radiological parameters were collected prospectively. The clinical outcomes were evaluated by visual analog scale (VAS) and Oswestry Disability Index (ODI) scores.

Results: The background data were comparable between the two groups. The mean operation time was longer in the PE-PLIF group. The PE-PLIF group showed benefits in less blood loss and shorter hospital stay. VAS and ODI scores significantly improved in both groups. However, the VAS score of low-back pain was lower in the PE-PLIF group. The satisfaction rate was 96.7% in both groups. The radiological outcomes were similar in both groups. In the PE-PLIF group, the fusion rate was 93.3%, and the cage subsidence rate was 6.7%; in the open PLIF group, the fusion and cage subsidence rates were 96.7% and 16.7%. There were minor complications in one patient in the PE-PLIF group and two in the open PLIF group.

Conclusions: The current study revealed that PE-PLIF is safe and effective compared with open PLIF. In addition, this minimally invasive technique may enhance postoperative recovery by reducing tissue damage and blood loss.

Keywords: Endoscope; Lumbar degenerative diseases; Minimally invasive; Posterior lumbar interbody fusion.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
a The intersection of the red cross indicates the puncture site. b Location of the puncture needle. c Location and range of the articular process molding marked on the specimen
Fig. 2
Fig. 2
a Range of the articular process molding at lumbar 4–5. b Range of the articular process molding at lumbar 5-sacral 1
Fig. 3
Fig. 3
a Deployment of the cage to an appropriate height after it was placed via the working channel. b and c Schematic diagram of surgery
Fig. 4
Fig. 4
A 57-year-old woman complained of low-back pain and left lower limb pain and numbness. Preoperative lateral X-ray (a) shows spondylolisthesis (I°). Postoperative lateral X-ray (b) shows complete resolution of the spondylolisthesis and normal disc height. Reconstructed CT image (c) shows the cage position and the range of articular process molding. Axial MRI (e, f) shows significant improvement in the spinal canal and complete nerve decompression. Coronal CT (g) at the last follow-up shows definite interbody fusion
See this image and copyright information in PMC

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