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A Cadaveric Comparison of Discectomy Performance During Transforaminal Lumbar Interbody Fusion Approach Using an
Venakat Boddapati1, Frank Yuk1, Sohrab Virk2
1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, NY.
Spine
|August 15, 2024
Summary
Endoscopic transforaminal lumbar interbody fusion (E-TLIF) offers comparable discectomy performance to tubular TLIF (T-TLIF). This cadaveric study found E-TLIF may be more efficient, with specific quadrant differences noted.
Area of Science:
- Spinal surgery techniques
- Minimally invasive spine procedures
- Lumbar fusion outcomes
Background:
- Adequate discectomy is crucial for lumbar fusion success in transforaminal lumbar interbody fusion (TLIF).
- Previous studies show variable discectomy rates (36.6%–80%) comparing open and minimally invasive TLIF.
- The efficacy of endoscopic TLIF (E-TLIF) for achieving adequate discectomy remains debated.
Purpose of the Study:
- To compare discectomy completeness between endoscopic TLIF (E-TLIF) and tubular TLIF (T-TLIF).
- To evaluate operative time and indirect decompression via interpedicular distance changes.
Main Methods:
- Cadaveric study comparing E-TLIF (14 discs) and T-TLIF (15 discs).
- Digital image analysis quantified percentage of discectomy in each disc quadrant.
- Operative time and change in interpedicular distance were measured.
Main Results:
- Overall discectomy rates were similar: 50.26%±7.38% for E-TLIF vs. 48.86%±6.98% for T-TLIF (P=0.61).
- E-TLIF showed significantly better discectomy in quadrant 2 (50.13%±14.00% vs. 39.02%±10.18%, P=0.02).
- E-TLIF was faster (15.22 min vs. 20.00 min, P=0.048) with no significant difference in interpedicular distance.
Conclusions:
- Endoscopic TLIF (E-TLIF) can achieve comparable discectomy rates to tubular TLIF (T-TLIF).
- E-TLIF demonstrated potential for increased efficiency.
- Further research is needed to optimize E-TLIF instrumentation and efficiency.
