Microendoscope-assisted posterior lumbar interbody fusion: a technical note

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Lumbar interbody fusion has various surgical approaches.
• Minimally invasive techniques aim to reduce soft tissue damage.
• Microendoscope-assisted posterior lumbar interbody fusion (ME-PLIF) is a novel technique for lumbar spine degeneration.

Purpose of the Study:

• To report a novel microendoscope-assisted posterior lumbar interbody fusion (ME-PLIF) technique.
• To evaluate the clinical and radiological outcomes of ME-PLIF for lumbar spine degeneration.

Main Methods:

• 48 patients underwent one-level ME-PLIF using an 18-mm tubular retractor system.
• Decompression, discectomy, autologous bone grafting, and cage insertion were performed.
• Percutaneous pedicle screws were inserted, and outcomes were assessed using ODI and JOA scores and fusion rates.

Main Results:

• Mean operation time was 102 minutes, mean blood loss was 86 mL.
• Significant improvements in Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) scores were observed.
• No pseudarthrosis occurred; one deep wound infection and four dural tears were reported with good recovery.

Conclusions:

• ME-PLIF yielded good clinical and radiological results for lumbar spine degeneration.
• Advantages include enhanced visual field and operability, leading to reduced soft tissue damage.
• ME-PLIF appears to be a safe and minimally invasive treatment option, though long-term follow-up is needed.