Heo Dong Hwa, Hong Young Ho, Lee Dong Chan, Chung Hun Jae, Park Choon Keun
Department of Neurosurgery, Endoscopic Spine Surgery Center, Seoul Bumin Hospital, Seoul, Korea.
Department of Neurosurgery, Bundang Barunsesang Hospital, Seongnam, Korea.
Neurospine. 2020 Jul;17(Suppl 1):S129-S137. doi: 10.14245/ns.2040178.089. Epub 2020 Jul 31.
Biportal endoscopic transforaminal lumbar interbody fusion (TLIF) may have advantages of minimally invasive fusion surgery as well as those of endoscopic surgery. The purpose of this study was to present the biportal endoscopic TLIF technique along with video presentations and a review of the literature on this technique. Basically, the biportal endoscopic TLIF technique is similar to minimally invasive TLIF with a tubular retractor. There were 2 options in the biportal endoscopic TLIF procedures. The first was the insertion of one long TLIF cage and the other was the insertion of 2 short posterior lumbar interbody fusion (PLIF) cages. After the interbody fusion procedures, percutaneous pedicles screw fixation was performed. Biportal endoscopic TLIF achieved complete neural decompression through laminectomy and facetectomy like conventional TLIF. Endplate preparation was performed completely under a clear and magnified endoscopic view. It was also feasible to insert a large TLIF cage or 2 cages for PLIF without exiting nerve root injury. Biportal endoscopic TLIF might have the advantages of endoscopic surgery as well as minimally invasive fusion surgery. Direct neural decompression, endplate preparation under endoscopic guidance, and the insertion of a large TLIF cage or 2 PLIF cages may be the merits of biportal endoscopic lumbar fusion procedures.
双孔道内镜下经椎间孔腰椎椎间融合术（TLIF）可能兼具微创融合手术和内镜手术的优势。本研究的目的是介绍双孔道内镜下TLIF技术，并附上视频演示以及对该技术的文献综述。基本上，双孔道内镜下TLIF技术类似于使用管状牵开器的微创TLIF。双孔道内镜下TLIF手术有两种选择。第一种是植入一个长的TLIF椎间融合器，另一种是植入两个短的后路腰椎椎间融合（PLIF）椎间融合器。椎间融合手术后，进行经皮椎弓根螺钉固定。双孔道内镜下TLIF像传统TLIF一样通过椎板切除术和小关节突切除术实现了完全的神经减压。终板准备在清晰放大的内镜视野下完全完成。植入一个大的TLIF椎间融合器或两个用于PLIF的椎间融合器且不损伤神经根也是可行的。双孔道内镜下TLIF可能兼具内镜手术和微创融合手术的优势。直接神经减压、在内镜引导下进行终板准备以及植入一个大的TLIF椎间融合器或两个PLIF椎间融合器可能是双孔道内镜下腰椎融合手术的优点。
