Joint Training Base of Jinzhou Medical University, China Postgraduate Training Base of The Fourth Medical Center of PLA General Hospital, Hospital of Jinzhou, Medical University, Beijing, China.
Department of Orthopedic Surgery, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
World Neurosurg. 2022 Feb;158:e618-e626. doi: 10.1016/j.wneu.2021.11.030. Epub 2021 Nov 12.
We sought to introduce technical notes of full endoscopic lumbar interbody fusion (FE-LIF) with an anterior expandable cylindrical fusion cage.
This study retrospectively reviewed patients who underwent FE-LIF with an anterior expandable cylindrical fusion cage through transforaminal or interlaminar approaches from August 2018 to April 2019. Patient demographics and operation-related complications were recorded. Clinical and radiologic outcomes were evaluated at 1 year after surgery.
A total of 32 patients (34 segments) were included in this study. Among them, 14 received full endoscopic transforaminal lumbar interbody fusion and 18 received full endoscopic interlaminar lumbar interbody fusion. There were significant differences in interbody fusion indications between the 2 groups (P < 0.05). All operations were successfully completed without complications. Postoperative lumbar magnetic resonance imaging showed that nerve decompression was sufficient in all patients, and the visual analog scale scores of low back pain and leg pain, the Oswestry Disability Index scores, and sensory and muscle strength were significantly improved after surgery (P < 0.01). The MacNab score included 9 excellent ratings, 4 good ratings, and 1 fair rating in the full endoscopic transforaminal lumbar interbody fusion group and included 10 excellent ratings and 8 good ratings in the full endoscopic interlaminar lumbar interbody fusion group; the scores were not significantly different between the 2 groups at 1 year after surgery (P > 0.05). Complete interbody fusion was achieved in both groups according to computed tomography at 1 year after surgery.
FE-LIF is a safe and effective minimally invasive lumbar surgery with an anterior expandable cylindrical fusion cage.
本研究旨在介绍经皮椎间孔入路或经椎间孔入路内镜下前路可扩张柱状融合 cage 行全内镜腰椎椎间融合术（FE-LIF）的技术要点。
本研究回顾性分析了 2018 年 8 月至 2019 年 4 月期间采用前路可扩张柱状融合 cage 行经皮椎间孔入路或经椎间孔入路内镜下 FE-LIF 的患者。记录患者的人口统计学资料和手术相关并发症。术后 1 年评估临床和影像学结果。
本研究共纳入 32 例（34 个节段）患者。其中，14 例行全内镜经皮椎间孔腰椎椎间融合术，18 例行全内镜经椎间孔腰椎椎间融合术。两组患者的椎间融合适应证存在显著差异（P < 0.05）。所有手术均顺利完成，无并发症发生。术后腰椎磁共振成像显示所有患者神经减压充分，术后腰痛和腿痛的视觉模拟评分、Oswestry 功能障碍指数评分以及感觉和肌力均显著改善（P < 0.01）。全内镜经皮椎间孔腰椎椎间融合组中，MacNab 评分包括 9 个优级评定、4 个良级评定和 1 个可级评定；全内镜经椎间孔腰椎椎间融合组中，MacNab 评分包括 10 个优级评定和 8 个良级评定；术后 1 年两组间评分差异无统计学意义（P > 0.05）。术后 1 年，两组均通过 CT 检查证实完全椎间融合。
FE-LIF 是一种安全有效的微创腰椎手术，采用前路可扩张柱状融合 cage。
