Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note

Brain Sciences

卷:11

Jun-Hyung Lee¹  Jin-Woo An²  Jun-Hwan Park³  Yeon-Jin Lee⁴  Inkyung Lee⁴  Hyeun-Sung Kim⁴  Myeong-Hun Kim⁴  Pang-Hung Wu⁴  Il-Tae Jang⁴  Jong-Sung Park⁴ 

[1] Department of Internal Medicine, Chosun University School of Medicine, Gwangju 61452, Korea;

[2] Nanoori Hospital Spine And Joints Clinic, Dubai 66566, United Arab Emirates;

[3] Neurosurgery Department, Medical School University, 4032 Debrecen, Hungary;

[4] Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea;

关键词: endoscopic spine surgery;    transforaminal lumbar interbody fusion;    degenerative spine disease;    endoscopic lumbar interbody fusion;    spinal fusion;    minimally invasive spine surgery;   

DOI  :  10.3390/brainsci11091169

来源: DOAJ

【 摘 要 】

Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging angle, and operation time (inferior articular process resection time/total operation time) and clinical evaluation were made. Result: 48 cases of inside-out and 38 cases of outside-in cases were included. Compared to inside-out, the outside-in approach had significantly less operative time required to resect inferior articular process: 36.55 ± 10.37, and total operative time: 87.45 ± 20.14 min compared to 49.83 ± 23.97 and 102.56 ± 36.53 min, respectively, for the inside-out approach, p < 0.05. Compared to the preoperative state, both cohorts achieved significant improvement of VAS and ODI at post-operative 1 week, 3 months and at final follow up. Both cohorts achieved statistically significant increased disc height with 5.00 ± 2.87 mm, 5.49 ± 2.33 mm and statistically significant improvement in coronal wedge angle with 1.76 ± 1.63°, 3.24 ± 2.92° in the inside-out and outside-in approaches respectively. Conclusions: Complete removal of inferior articular process is the key part of endoscopic fusion with two methods that can be applied: an inside-out approach or an outside-in approach. Comparing both techniques, the outside-in approach has a shorter operative time required for inferior articular process resection and total length of operation with similar good clinical and radiological outcomes.

【 授权许可】

Unknown