RT Journal Article
SR Electronic
T1 Endoscopic Transforaminal Lumbar Interbody Fusion With a Single Oblique PEEK Cage and Posterior Supplemental Fixation
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 7126
DO 10.14444/7126
A1 Álvaro Dowling
A1 Kai-Uwe Lewandrowski
YR 2020
UL http://ijssurgery.com//content/early/2020/10/27/7126.abstract
AB Background To demonstrate the feasibility of an endoscopically assisted minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) and to study clinical outcomes with the use of a static oblique bullet-shaped cannulated poly-ether-ether-ketone (PEEK) lumbar interbody fusion cage in conjunction with platelet enriched plasma infused allograft cancellous chips and posterior supplemental fixation.Methods In this retrospective study of 43 patients who underwent endoscopically assisted MIS-TLIF for spondylolisthesis (53.5%) and stenosis (46.3%), the Oswestry Disability Index, the visual analog scale (VAS) for back and leg pain, and the modified Macnab criteria were used as primary clinical outcome measures. Clinical outcomes were cross-tabulated against fusion grade using the Bridwell classification of interbody fusion.Results The majority of patients (90.7%) had excellent (8/43; 18.6%) and good (31/43; 72.1%) Macnab outcomes. There were significant VAS back score reductions from an average preoperative values of 8.9070 to a postoperative VAS score of 3.8605, and a score of 2.7674 at final follow-up (P < .0001). The reductions in the VAS leg scores were also significant from preoperative score of 5.58 to a postoperative value of 2.16, and a final follow-up score of 1.67 (P < .0001); the Oswestry Disability Index score went from a preoperative value of 54.4 to 23.3 postoperatively and 18.5 at the final follow-up ( P < .0001). The vast majority of patients (92.9%) with Bridwell grade I fusion had excellent and good Macnab outcomes (P = .027).Conclusions The authors recommend the use of an endoscope as an adjunct to MIS-TLIF, a minimally invasive spinal surgery technique in which many surgeons may be well versed and have a great deal of experience. Clinical outcomes with the endoscopic interbody fusion procedure with a static PEEK cage in conjunction with platelet-enriched bone allograft were favorable.Level of Evidence 3.Clinical Relevance Feasibility study.