Article Figures & Data
Figures
- Figure 1
Nitinol wire inserted through 18G spinal needle into the disc space after fluoroscopic confirmation of correct positioning.
- Figure 2
Working cannula inserted after sequential dilation.
- Figure 3
Discectomy and endplate preparation performed through working cannula with aid of fluoroscopy using micropituitary rongeurs (left), expandable shavers (middle), and back-biting currettes (right).
- Figure 4
Expandable titanium interbody cage before expansion (left) and after expansion with a torque-limiting handle (middle). Final height and position of the expandable cage was confirmed with intraoperative fluoroscopy (right).
- Figure 5
Final intraoperative fluoroscopic images following insertion of expandable titanium interbody cage and instrumentation of bilateral pedicles with screws and rods.
- Figure 6
Lateral lumbar radiograph demonstrating the measurement of segmental lordosis, posterior disc height, and amount of listhesis.
- Figure 7
Postoperative and 1-year photographs of stab incisions following single-level endoscopic transforaminal lumbar interbody fusion.
- Figure 8
Preoperative (top) and postoperative (bottom) lumbar spine radiographs of a patient who underwent successful endoscopic transforaminal lumbar interbody fusion for treatment of lower limb radiculopathy and lower back pain with significant improvement of symptoms at 1 year. Postoperative radiographs demonstrate reduction of L4-L5 anterolisthesis and improvement of posterior disc height.
Tables
Demographics Endoscopic TLIF (n = 12) Minimally Invasive TLIF (n = 34) P Value Sex, man:woman 5:7 17:17 0.619 Age, y 67.4 ± 7.1 66.3 ± 9.9 0.684 BMI, kg/m2 25.4 ± 4.8 25.3 ± 4.1 0.952 Spinal level operated L3–L4 1 (8%) 3 (9%) 0.336 L4–L5 11 (92%) 27 (79%) L5–S1 0 (0%) 4 (12%) Abbreviation: TLIF, transforaminal lumbar interbody fusion.
- Table 2
Comparison of postoperative outcomes between endoscopic TLIF and minimally invasive TLIF.
Outcome Endoscopic TLIF Minimally Invasive TLIF P Value Clinical outcomes Length of stay, d 1.8 ± 0.9 4.7 ± 2.9 <0.001 Blood loss, mL 83 ± 75 181 ± 225 0.033 Surgery duration, min 165 ± 15 259 ± 43 <0.001 Patient-reported outcome scores VAS back pain 0.6 ± 1.5 0.7 ± 1.8 0.777 VAS lower limb pain 0.8 ± 1.9 0.3 ± 1.1 0.355 Oswestry Disability Index 19.2 ± 10.0 15.9 ± 13.1 0.378 Neurogenic Symptom Score 12.1 ± 17.4 14.6 ± 16.4 0.673 Radiological outcomes Change in segmental lordosis, ° 2.9 ± 1.9 2.3 ± 2.6 0.444 Change in posterior disc height, mm 2.7 ± 1.2 2.0 ± 1.4 0.145 Change in listhesis, mm −4.4 ± 2.8 −3.1 ± 2.4 0.157 Abbreviation: VAS, visual analog score.
Note: Data presented as mean ± SD.
Endoscopic TLIF Preoperative Postoperative Difference P Value Patient-reported outcome scores VAS back pain 5.5 ± 3.0 0.6 ± 1.5 −4.9 ± 2.7 <0.001 VAS lower limb pain 5.8 ± 3.0 0.8 ± 1.9 −4.9 ± 2.8 <0.001 Oswestry Disability Index 39.8 ± 14.1 19.2 ± 10.0 −20.7 ± 15.0 <0.001 Neurogenic Symptom Score 35.4 ± 11.2 12.1 ± 17.4 −23.3 ± 21.5 0.003 Radiological outcomes Segmental lordosis, ° 6.0 ± 3.1 8.9 ± 1.5 2.9 ± 1.9 <0.001 Posterior disc height, mm 6.8 ± 1.5 9.5 ± 1.3 2.7 ± 1.2 <0.001 Listhesis, mm 7.1 ± 3.7 2.7 ± 1.4 −4.4 ± 2.8 <0.001 Abbreviations: TLIF, transforaminal lumbar interbody fusion; VAS, visual analog score.
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