Endoscopic Transforaminal Lumbar Interbody Fusion With a Single Oblique PEEK Cage and Posterior Supplemental Fixation

The quantile-quantile plot of the endoscopy patients' age shows normal distribution. The average age was 65.66 ± 11.90 years SD, ranging from 35 to 93 years.

An exemplary case of a 63-year-old female patient who underwent endoscopically assisted minimally invasive surgery with transforaminal lumbar interbody fusion. Shown is (A) the preoperative sagittal MRI scan showing the sacral slope, (B) positioning and draping of the patient, and (C-E) various steps of the transforaminal interspace preparation with (C) reamers, (D) Kerrison, and (E) chisels.

Intraoperative steps of the fusion surgery of the patient shown in Figure 3 showing the (A) endoscopic view of the decorticated endplates and the empty interspace, (B) the aspiration of bone marrow, (C) the enrichment of allograft chips with bone marrow aspirate and placement through a funnel into the intervertebral disc space, (D) the posterior supplemental percutaneously placed pedicle screw system, (E) the oblique bullet-nosed cannulated interbody fusion cage placed over a nitinol guidewire into the (F) intervertebral disc space into its (G) final position under fluoroscopic control.

Postoperative posteroanterior and lateral standing x-rays of the same 63-year-old female patient illustrated in Figures 2 and 3 who underwent endoscopically assisted minimally invasive surgery with transforaminal lumbar interbody fusion are shown. These radiographs were taken at 6 weeks postoperatively.