scholarly journals Percutaneous endoscopic posterior lumbar interbody fusion(PEPLIF): technical note

2020 ◽  
Author(s):  
Liming He ◽  
Haoyu Feng ◽  
Xun Ma ◽  
Qiang Chang ◽  
Jianjun Chang ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Technical Note ◽  
Lumbar Discectomy ◽  
Lumbar Interbody Fusion ◽  
Effective Technique ◽  
Endoscopic View ◽  
Transforaminal Approach ◽  
Endoscopic Lumbar Discectomy

Abstract Background: Endoscopic lumbar interbody fusion is based on endoscopic lumbar discectomy, a well-established and widely used clinical procedure. Endoscopic lumbar interbody fusion has several key advantages over other types of procedures, including that it is minimally invasive, more precise, safer, and provides better visualization. Most surgeons use the transforaminal approach for this surgery. Here, we report the first percutaneous endoscopic posterior lumbar interbody fusion (PEPLIF). Methods: The authors introduce the PEPLIF technique with step by step instructions and describe key procedures in detail. Tips for controlling hemorrhages and avoiding complications during the procedure are presented. The authors also discuss the indications and advantages of applying the PEPLIF technique.Results: PEPLIF is a repeatable lumbar fusion technique.Conclusions: PEPLIF is a feasible and effective technique for the fusion of L4-5 and L5-S1 (especially L5-S1). All procedures are completed in full using endoscopy without replacing the cannula. The endoscopic view is similar to that of an open posterior lumbar interbody fusion, thus reducing the learning curve.

scholarly journals Comparing Oblique Lumbar Interbody Fusion with Lateral Screw Fixation and Transforaminal Full-Endoscopic Lumbar Discectomy (OLIF-TELD) and Posterior Lumbar Interbody Fusion (PLIF) for the Treatment of Adjacent Segment Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Zhuo Yang ◽  
Jianjun Chang ◽  
Lin Sun ◽  
Chien-Min Chen ◽  
Haoyu Feng
Keyword(s):  
Interbody Fusion ◽  
Screw Fixation ◽  
Lumbar Fusion ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Bleeding ◽  
Oblique Lumbar Interbody Fusion ◽  
Endoscopic Lumbar Discectomy

Background. A potential long-term complication of lumbar fusion is the development of adjacent segment disease (ASD), which may require surgical intervention and adversely affect outcomes. A high incidence of recurrent ASD was reported in patients who underwent the second (repeat) PLIF for symptomatic ASD. Herein, a feasible method, oblique lumbar interbody fusion combined with transforaminal endoscopic lumbar discectomy (OLIF-TELD) for dealing with adjacent lumbar disc herniation with upward or downward migration after lumbar spinal fusion, was proposed. Methods. A total of 19 patients who underwent revision surgery at ASD were consecutively enrolled. Clinical efficacy analysis included operative time, intraoperative bleeding, visual analogue scale (VAS) score, Oswestry dysfunction index (ODI) score, and Japanese orthopaedic association (JOA) assessment treatment score. Results. Among them, 11 patients were treated in a new surgical strategy, which is OLIF-TELD, and 8 patients underwent PLIF. There was no statistically significant difference between the two groups in terms of age, gender, and preoperative scores of VAS, ODI, and JOA. The operative duration was shorter, and intraoperative bleeding was less in the OLIF-TELD group compared with the PLIF group. PLIF had the greatest blood loss, and the OLIF-TELD group had lower VAS scores than the PLIF group postoperatively. The symptoms of all patients improved postoperatively with statistical significance. Conclusion. OLIF with lateral screw fixation combined with TELD may be an alternative surgical method for the treatment of adjacent lumbar disc herniation with upward or downward migration after lumbar fusion surgery.

scholarly journals A comparative study of functional outcome between posterior lumbar fusion and posterior lumbar interbody fusion in spondylolisthesis

2021 ◽  
Vol 7 (3) ◽  
pp. 544
Author(s):  
Harpreet Singh ◽  
Dhruv Patel ◽  
Sangam Tyagi ◽  
Krushna Saoji ◽  
Tilak Patel ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Interbody Fusion ◽  
Operative Time ◽  
Lumbar Fusion ◽  
Tertiary Care ◽  
Posterior Lumbar Interbody Fusion ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Tertiary Care Centre ◽  
Posterior Lumbar Fusion

<p class="abstract"><strong>Background:</strong> Spondylolisthesis is condition in which one vertebra slips over other vertebra. This study has been done to compare the functional outcome and complications of two techniques: posterior lumbar fusion (intertransverse fusion) and posterior lumbar interbody fusion.</p><p class="abstract"><strong>Methods:</strong> Total 20 patients with spondylolisthesis admitted in a tertiary care centre in Rajasthan were allotted alternatively in posterior lumbar fusion (PLF) group and posterior lumbar interbody fusion (PLIF) group. In PLF, fusion was done by placing bone graft between transverse processes and around facets. In PLIF, fusion was bone by placing cage in between vertebral bodies.</p><p class="abstract"><strong>Results:</strong> 20 patients were included in our study with female predominance (65%). Mean age was 54.2 years (PLF=58.4 and PLIF=50.2). 70% patients have L4-L5 level spondylolisthesis. Average operative time was less in PLF group, which is statistically significant. Functional outcome was measured by using visual analogue scale (VAS) score and Japanese orthopedics association score (JOAS) at 3 weeks, 3 months and 6 months. There is a significant decrease between preoperative VAS and at 6 months, in both PLF and PLIF group. JOAS was significantly increased at 6 months in both PLF and PLIF group as compared to preoperative score. But difference in JOAS at 6 months is not significant between PLF and PLIF.</p><p class="abstract"><strong>Conclusions:</strong> Both PLF and PLIF are equally effective for spondylolisthesis. Both techniques have same satisfactory results. As PLIF is more invasive technique, more operative time and more complications are seen.</p>

scholarly journals Working Cannula-Based Endoscopic Foraminoplasty: A Technical Note

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Suxi Gu ◽  
Kedong Hou ◽  
Wei Jian ◽  
Jianwei Du ◽  
Songhua Xiao ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Operation Time ◽  
Skin Incision ◽  
Technical Note ◽  
Lumbar Discectomy ◽  
New Technique ◽  
Foraminal Stenosis ◽  
Transforaminal Approach ◽  
A New Technique ◽  
Endoscopic Lumbar Discectomy

Purpose. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive disc surgery that can be performed under local anesthesia and requires only an eight-mm skin incision. For the patients with lumbar foraminal stenosis, the migrated disc is difficult to remove with a simple transforaminal approach. In such cases, the foraminoplasty techniques can be used. However, obtaining efficient foramen enlargement while minimizing radiation exposure and protecting the nerves can be challenging. Methods. In this study, we propose a new technique called the Kiss-Hug maneuver. Under endoscopic viewing, we used the bevel tip of a working cannula as a bone reamer to enlarge the foramen. This allowed us to efficiently enlarge the lumbar foramen endoscopically without the redundancy and complications associated with reamers or trephines. Results. Details of the four steps of the Kiss-Hug maneuver are reported along with adverse events. The advantages of this new technique include minimizing radiation exposure to both the surgeon and the patient and decreasing the overall operation time. Conclusion. The endoscopic Kiss-Hug maneuver is a useful and reliable foraminoplasty technique that can enhance the efficiency of foraminoplasty while ensuring patient safety and reducing radiation exposure.

Vertebral osteolytic defect due to cellulose particles derived from gauze fibers after posterior lumbar interbody fusion

2014 ◽  
Vol 21 (6) ◽  
pp. 877-881 ◽  
Author(s):  
Shota Takenaka ◽  
Yoshihiro Mukai ◽  
Noboru Hosono ◽  
Kosuke Tateishi ◽  
Takeshi Fuji
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Interbody Fusion ◽  
Histopathological Examination ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Body Type ◽  
Initial Surgery

Vertebral cystic lesions may be observed in pseudarthroses after lumbar fusion surgery. The authors report a rare case of pseudarthrosis after spinal fusion, accompanied by an expanding vertebral osteolytic defect induced by cellulose particles. A male patient originally presented at the age of 69 years with leg and low-back pain caused by a lumbar isthmic spondylolisthesis. He underwent a posterior lumbar interbody fusion, and his neurological symptoms and pain resolved within a year but recurred 14 months after surgery. Radiological imaging demonstrated a cystic lesion on the inferior endplate of L-5 and the superior endplate of S-1, which rapidly enlarged into a vertebral osteolytic defect. The patient underwent revision surgery, and his low-back pain resolved. A histopathological examination demonstrated foreign body–type multinucleated giant cells, containing 10-μm particles, in the sample collected just below the defect. Micro–Fourier transform infrared spectroscopy revealed that the foreign particles were cellulosic, presumably originating from cotton gauze fibers that had contaminated the interbody cages used during the initial surgery. Vertebral osteolytic defects that occur after interbody fusion are generally presumed to be the result of infection. This case suggests that some instances of vertebral osteolytic defects may be aseptically induced by foreign particles. Hence, this possibility should be carefully considered in such cases, to help prevent contamination of the morselized bone used for autologous grafts by foreign materials, such as gauze fibers.

A Compaction Bone Grafting Technique Leads to Early Bone Fusion in Cases of Posterior Lumbar Interbody Fusion

2015 ◽  
Vol 12 (1) ◽  
pp. 31-38
Author(s):  
Mikinobu Takeuchi ◽  
Norimitsu Wakao ◽  
Mitsuhiro Kamiya ◽  
Atsuhiko Hirasawa ◽  
Shuntaro Hanamura ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Psoas Muscle ◽  
Lumbar Interbody Fusion ◽  
Impaction Bone Grafting ◽  
Computed Tomographic ◽  
Bone Fusion ◽  
Grafting Technique

Abstract BACKGROUND The impaction bone grafting technique is a popular approach for achieving complete bone fusion during hip surgery or total knee arthroplasty. We hypothesized that compaction bone grafting (CBG), a modified version of impaction bone grafting, could be applied to lumbar fusion surgery. OBJECTIVE To compare the bone fusion rates and durations achieved using the CBG technique and a conventional loose bone grafting technique. METHODS We retrospectively reviewed 89 patients who underwent single-level posterior lumbar interbody fusion at the university hospital; 35 other posterior lumbar interbody fusion recipients were excluded due to undergoing multilevel fusion, prior lumbar surgery, trauma, infection, or inadequate computed tomographic data. Computed tomographic-based bone fusion assessments were obtained using the Brantigan, Steffee, and Fraser criteria at 1 and 2 years after surgery. RESULTS The baseline characteristics of the CBG (n = 42) and loose bone grafting (n = 47) groups did not significantly differ. Fusion assessments indicated that significantly superior bone fusion rates were achieved at 1 year after surgery in the CBG group than in the loose bone grafting group (P = .04, χ2 test). However, the bone fusion rates of the 2 groups at 2 years after surgery did not significantly differ (P = .3). A nonsymptomatic surgical complication occurred in the CBG group when a spacer was inserted into the intervertebral space; specifically, the spacer slipped out of the right psoas muscle because a large quantity of compaction bone grafts disrupted the cage's pathway. CONCLUSION In posterior lumbar interbody fusion surgeries, bone fusion was achieved more quickly with the CBG technique than with the conventional technique.

Pedicle screw fixation for isthmic spondylolisthesis: does posterior lumbar interbody fusion improve outcome over posterolateral fusion?

2003 ◽  
Vol 99 (2) ◽  
pp. 143-150 ◽  
Author(s):  
Giovanni La Rosa ◽  
Alfredo Conti ◽  
Fabio Cacciola ◽  
Salvatore Cardali ◽  
Domenico La Torre ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Fusion Rate ◽  
Pedicle Screw Fixation ◽  
Posterolateral Fusion ◽  
Lumbar Interbody Fusion ◽  
Isthmic Spondylolisthesis ◽  
Content Type ◽  
Fine Print

Object. Posterolateral fusion involving instrumentation-assisted segmental fixation represents a valid procedure in the treatment of lumbar instability. In cases of anterior column failure, such as in isthmic spondylolisthesis, supplemental posterior lumbar interbody fusion (PLIF) may improve the fusion rate and endurance of the construct. Posterior lumbar interbody fusion is, however, a more demanding procedure and increases costs and risks of the intervention. The advantages of this technique must, therefore, be weighed against those of a simple posterior lumbar fusion. Methods. Thirty-five consecutive patients underwent pedicle screw fixation for isthmic spondylolisthesis. In 18 patients posterior lumbar fusion was performed, and in 17 patients PLIF was added. Clinical, economic, functional, and radiographic data were assessed to determine differences in clinical and functional results and biomechanical properties. At 2-year follow-up examination, the correction of subluxation, disc height, and foraminal area were maintained in the group in which a PLIF procedure was performed, but not in the posterolateral fusion—only group (p < 0.05). Nevertheless, no statistical intergroup differences were demonstrated in terms of neurological improvement (p = 1), economic (p = 0.43), or functional (p = 0.95) outcome, nor in terms of fusion rate (p = 0.49). Conclusions. The authors' findings support the view that an interbody fusion confers superior mechanical strength to the spinal construct; when posterolateral fusion is the sole intervention, progressive loss of the extreme correction can be expected. Such mechanical insufficiency, however, did not influence clinical outcome.

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