Endoscope-Assisted Extreme-Lateral Interbody Fusion: Preliminary Experience and Technical Note

Area of Science:

• Minimally Invasive Spine Surgery
• Surgical Technology
• Spinal Fusion Techniques

Background:

• Extreme lateral lumbar interbody fusion (XLIF) offers a safe and effective approach for spinal fusion.
• Challenges in XLIF include limited visualization of critical structures and difficulties in endplate preparation.
• Endoscope-assisted (EA) techniques are being explored to overcome these limitations.

Purpose of the Study:

• To evaluate the safety and feasibility of endoscope-assisted XLIF (EA-XLIF).
• To compare EA-XLIF with conventional XLIF (c-XLIF) regarding surgical outcomes.
• To identify specific surgical steps where EA-XLIF provides enhanced visualization.

Main Methods:

• Retrospective single-center study of consecutive patients undergoing XLIF.
• Comparison of EA-XLIF (n=6) and c-XLIF (n=35) procedures.
• Data collected included surgical duration, estimated blood loss (EBL), complications, and postoperative outcomes.

Main Results:

• EA-XLIF did not increase surgical duration or EBL compared to c-XLIF.
• No perioperative or postoperative complications were observed in the EA-XLIF group.
• Clinical and radiologic outcomes were similar between EA-XLIF and c-XLIF groups at short-term follow-up.

Conclusions:

• Endoscope-assisted XLIF is a safe adjunct procedure.
• EA-XLIF improves visualization for critical steps like landmark identification and endplate preparation.
• The technique offers enhanced guidance for surgeons performing XLIF.