Two-Year Radiological Fusion Outcomes Following Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Using...

Area of Science:

• Spine surgery
• Minimally invasive techniques
• Orthopedic surgery

Background:

• Biportal endoscopic transforaminal lumbar interbody fusion (BESS-TLIF) is an emerging minimally invasive surgical approach.
• Evaluating long-term outcomes of novel surgical techniques is crucial for clinical adoption.

Purpose of the Study:

• To assess the two-year radiological fusion outcomes of single-level BESS-TLIF.
• To investigate the influence of bone graft composition on fusion rates.

Main Methods:

• Retrospective review of 51 patients undergoing single-level BESS-TLIF with a specific cage.
• Radiological fusion assessed via CT scans over 24 months using a three-grade system.
• Comparison of fusion rates between demineralized bone matrix (DBM) only and DBM with I-factor bone grafts.

Main Results:

• A high complete fusion rate of 96.1% was achieved at two years post-surgery.
• Bone graft composition was a significant factor influencing fusion.
• The DBM with I-factor group demonstrated significantly faster fusion achievement and a higher final fusion rate compared to DBM only.

Conclusions:

• Single-level BESS-TLIF with a porous titanium cage yields favorable two-year fusion results.
• Incorporating I-factor as an osteoinductive supplement accelerates solid arthrodesis.
• BESS-TLIF represents a promising minimally invasive option for lumbar interbody fusion.