Endoscopic Lateral Lumbar Interbody Fusion: Technical Note and Case Series

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Spinal Fusion Techniques

Background:

• Lateral Lumbar Interbody Fusion (LLIF) is a common procedure for degenerative lumbar disease.
• Traditional LLIF may lead to complications such as psoas and lumbar plexus injury due to muscle retraction.
• Endoscopic techniques offer potential to minimize these risks.

Purpose of the Study:

• To describe a novel minimally invasive endoscopic surgical technique for Lateral Lumbar Interbody Fusion (LLIF).
• To evaluate the safety and efficacy of this endoscopic modification in patients with degenerative lumbar disease.

Main Methods:

• Endoscopic LLIF (ELLIF) was performed in 3 patients.
• Procedures involved discectomy, endplate preparation, and cage insertion via a working channel endoscope.
• No expandable blade retractors were used, and surgeries were performed under neurophysiological monitoring.

Main Results:

• Significant improvement in pain and disability: mean VAS leg pain decreased from 9.3 to 1.7; mean ODI improved from 40 to 8.3 at 2-year follow-up.
• No complications, readmissions, or symptom recurrence were observed.
• Average hospital stay was 36 hours, with return to normal activities in 48 days.

Conclusions:

• Endoscopic LLIF is a minimally invasive technique with potential advantages including reduced muscle retraction and smaller incisions.
• This approach allows for indirect decompression and endoscopically visualized discectomy.
• The technique may lead to fewer complications, faster recovery, and good functional outcomes for patients.