Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Lumbar interbody fusion is standard for degenerative lumbar disorders but is invasive.
• Extraforaminal lumbar interbody fusion (ELIF) offers a less invasive posterolateral approach.
• Standard ELIF is technically demanding, limiting its widespread adoption.

Purpose of the Study:

• To introduce and evaluate a novel microendoscopy-assisted extraforaminal lumbar interbody fusion (mELIF) technique.
• To assess the safety, invasiveness, and clinical outcomes of the mELIF procedure.
• To determine the applicability of mELIF in treating degenerative lumbar conditions.

Main Methods:

• A posterolateral approach utilizing a tubular retractor was employed.
• Partial facetectomy and disc space preparation were performed under microendoscopy.
• Cage and bone graft insertion, followed by bilateral percutaneous screw-rod fixation, completed the procedure.

Main Results:

• Fifty-five patients underwent the mELIF procedure.
• Significant improvements were observed in Oswestry Disability Index and visual analogue scale scores.
• Over 90% of patients achieved excellent or good outcomes (Macnab criteria) with no major adverse events or revision surgeries.

Conclusions:

• Microendoscopy-assisted extraforaminal lumbar interbody fusion (mELIF) is a minimally invasive technique with minimal invasion of the spinal canal and posterior muscles.
• The mELIF technique yields favorable clinical results and a low complication rate.
• mELIF is a viable option for most single-level lumbar fusion procedures, including those at L5/S1.