Technical notes & surgical techniques
Technical note on Uniportal full endoscopic posterolateral approach transforaminal lumbar interbody fusion with reduction for grade 2 spondylolisthesis

https://doi.org/10.1016/j.inat.2020.100712Get rights and content
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Abstract

Background

Uniportal Endoscopic transforaminal posterolateral approach interbody fusion (Endo-TLIF) is becoming a popular method of fusion, it harnesses the advantage of both Trans Kambin approach endoscopic tranforaminal interbody fusion and biportal transforaminal interbody fusion into one single technique. There is no description of Endo-TLIF with reduction in Grade 2 isthmic spondylolisthesis in the spine literature.

Objective

Technical discussion on the management of grade 2 isthmic spondylolisthesis in an elderly population by Endo-TLIF.

Methods

Technique was applied in grade 2 isthmic spondylolisthesis with the focus on uniportal endoscopic transforaminal lumbar interbody fusion; particular attention was paid in endoscopic visualization to traversing and exiting nerve root to avoid neurological complications in reducing isthmic spondylolisthesis. Direct endoscopic visualization end plate preparation helped to avoid damage of end plates and ensure adequate disc preparations. Percutaneous rod fixation with complete reduction of isthmic spondylolisthesis of L4/5 was performed.

Results

Successful reduction of grade 2 isthmic spondylolisthesis with good post-operative clinical outcome was observed.

Conclusion

Full Uniportal Endoscopic Transforaminal Interbody Fusion is a new and evolving technique with potential advantages in end plate preparation, direct visualized neural decompression and safe placement of interbody fusion device. We showed a case of a patient with a grade 2 isthmic spondylolisthesis who had successful reduction of deformity and placement of a large size interbody cage with good post-operative clinical outcome.

Keywords

Endoscopic spine surgery
Transforaminal lumbar interbody fusion
Spondylolisthesis
Minimally invasive spine
Degenerative spine

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1

Dr. Hyeun-Sung Kim and Dr. Pang Hung Wu contributed equally to this work as first authors.