Advantages of Full-endoscopic Trans-Kambin's Triangle Lumbar Interbody Fusion for Degenerative Spondylolisthesis: Illustrative Cases

Abstract

Various approaches to lumbar interbody fusion have been described. The usefulness of full-endoscopic trans-Kambin's triangle lumbar interbody fusion has recently been reported. This technique has several advantages in patients with degenerative spondylolisthesis, including the ability to improve symptoms without decompression surgery. Moreover, given that the entire procedure is performed percutaneously, it can be performed without increasing the operation time or surgical invasiveness, even in obese patients. In this article, we discuss these advantages and illustrate them with representative cases.

Keywords: degenerative spondylolisthesis; full-endoscopic trans-Kambin's triangle lumbar interbody fusion (KLIF); minimally invasive procedure; obese.

Fig. 1

(A) Plain radiograph showing Meyerding grade 1 spondylolisthesis at L4. (B) T2-weighted magnetic resonance image (MRI) revealing spinal canal stenosis at L4/5. (C) Preoperative myelography. (D) Postoperative T2-weighted MRI confirming the expansion of the spinal canal at L4/5. (E) Postoperative radiograph showing the reduction of the slippage at L4/5.

Fig. 2

(A) Preoperative plain radiograph showing Meyerding grade 2 spondylolisthesis at L4. (B) T2-weighted MRI revealing spinal canal stenosis at L4/5. (C) Postoperative plain radiograph showing a change in spondylolisthesis from Meyerding grade 2 to grade 1.

Fig. 3

(A) Preoperative plain radiograph showing Meyerding grade 1 spondylolisthesis at L3. (B) T2-weighted MRI revealing left foraminal stenosis at L3/4 (arrow) with thick subcutaneous fat (double arrow). (C) Postoperative dynamic plain radiograph showing the reduction of the slippage at L3/4. (D) Postoperative T2-weighted MRI revealing the enlargement of the foramen at L3/4, and fat tissue around the L3 exiting nerve root was observed (arrow).