Endoscopic TLIF with Unilateral Pedicle Screw and Contralateral Translaminar Facet Screw Fixation : Technical Note and Early Outcomes
Abstract Study Design: Retrospective study.Objective:To evaluate outcomes and safety of endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for degenerative lumbar diseases.Summary of Background Data:There is no report about Endo-TLIF using unilateral pedicle screws and contralateral translaminar facet joint screw (UPS and TFS) fixation.Purpose: This paper evaluated the efficacy and safety of Endo-TLIF using UPS and TFS fixation in degenerative lumbar diseases.Methods:From August, 2018 to December, 2019, 21 patients with degenerative lumbar diseases were treated with Endo-TLIF. Clinical symptoms were evaluated at 1 month, 3 months, and the last follow-up after surgery. Outcomes were assessed by using the VAS back pain VAS leg pain, Oswestry disability index (ODI). Dural Sac Cross-sectional Area (DSCA), Foraminal Height (FH), Anterior Disc Height (ADH), Posterior Disc Height (PDH) and Lumbar Lordosis (LL).Results:The mean age of the cases was 62.9 years. The mean operation time was 198.7 min, the blood loss was 86.7 mL, and the length of incision was 5.7 cm. The mean time in bed was 34.3 hours, and the mean length of hospital stay was 15.1 days. The ODI scores improved from 64.1 to 13.3 (P < 0.05), the VAS score of back pain improved from 5.8 to 1.7 (P < 0.05), and the VAS score of leg pain improved from 6.2 to 1.6 (P < 0.05). ADH increased from 1.3 cm to 1.6 cm (P < 0.05), PDH increased from 0.7 cm to 1.0 cm (P < 0.05), FH increased from 1.7 cm to 2.0 cm (P < 0.05), and DSCA increased from 147 mm2 to 40 mm2 (P < 0.05). No serious complications occurred during the follow-up period.Conclusions:Endo-TLIF with UPS and TFS can improve the clinical symptoms of patients with degenerative lumbar diseases. The early curative effect was satisfactory.