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Related Experiment Video

Updated: Sep 11, 2025

Novel Mini-open Transforaminal Lumbar Interbody Fusion
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Comparative Study between Full-Endoscopic Transforaminal Approach Lumbar Interbody Fusion (TF-LIF) Using PETLIF

Katsuhisa Yamada1, Ken Nagahama1,2, Hisataka Suzuki1,3

  • 1Department of Orthopaedic Surgery, Hokkaido University Hospital, Sapporo, Japan.

Spine Surgery and Related Research
|August 11, 2025
PubMed
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Percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) offers excellent fusion rates and clinical outcomes with less blood loss compared to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). However, PETLIF carries a risk of nerve root injury, necessitating careful technique.

Area of Science:

  • Spine Surgery
  • Minimally Invasive Procedures
  • Orthopedic Surgery

Background:

  • Degenerative lumbar spine disorders are a common cause of chronic low back pain and disability.
  • Transforaminal lumbar interbody fusion (TLIF) is a surgical technique used to treat these conditions.
  • Advancements in endoscopic technology have led to the development of percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) as an alternative to traditional minimally invasive TLIF (MIS-TLIF).

Purpose of the Study:

  • To compare the clinical outcomes of full-endoscopic transforaminal lumbar interbody fusion (PETLIF) with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
  • To evaluate fusion rates, blood loss, neurological complications, and radiographic changes between the two surgical techniques.

Main Methods:

Keywords:
Kambin's triangledegenerative lumbar spine disorderfull-endoscopic lumbar spine surgeryminimally invasive transforaminal lumbar interbody fusion

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  • A retrospective study comparing 102 patients who underwent PETLIF with 100 randomly selected patients who underwent MIS-TLIF for degenerative lumbar spine disorders.
  • Patients were followed up for 2 years post-surgery.
  • Data collected included surgical parameters, radiographic assessments (fusion rate, lordosis angle), and clinical outcomes.

    • Main Results:

    • Both PETLIF and MIS-TLIF demonstrated high fusion rates (95.1% and 96.0%, respectively).
    • PETLIF resulted in significantly lower blood loss compared to MIS-TLIF.
    • MIS-TLIF showed a significantly greater increase in local lordosis angle, while PETLIF had a higher incidence of transient neurologic disorders, which resolved within 3 months.

    Conclusions:

    • PETLIF is a viable minimally invasive option for lumbar interbody fusion, offering comparable fusion rates and clinical outcomes to MIS-TLIF with the advantage of reduced blood loss.
    • Potential risks associated with PETLIF include exiting nerve root injury, highlighting the need for meticulous surgical technique and strategies to optimize Kambin's triangle.
    • Both techniques are effective, but the choice may depend on patient factors and surgeon expertise, considering the specific complication profiles.