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Instrumented laparoscopic spinal fusion. Preliminary Results
J F Zucherman1, T A Zdeblick, S A Bailey
1St. Mary's Spine Center, San Francisco, California, USA.
Spine
|September 15, 1995
Summary
This study shows laparoscopic interbody fusion is effective for lumbar fusion, offering reduced hospital stays and recovery times. While it has a learning curve, the technique provides advantages over traditional open surgery.
Area of Science:
- Minimally Invasive Spine Surgery
- Spinal Fusion Techniques
- Laparoscopic Surgery
Background:
- Endoscopic surgery advances lower morbidity and expense compared to open procedures.
- Developed prototype delivery instruments for laparoscopic fusion cage delivery.
Purpose of the Study:
- Evaluate a novel laparoscopic instrumented interbody fusion technique.
- Assess potential for reduced hospitalization, recovery time, discomfort, and cost.
- Compare rehabilitative aspects to traditional fusion methods.
Main Methods:
- Laparoscopic instrumented interbody fusions using custom delivery instrumentation and BAK fusion cages.
- Performed transperitoneally with CO2 insufflation and video-assisted visualization.
- Utilized three 10-mm incisions and one 13-20 mm incision for one-level procedures.
Main Results:
- Seventeen patients (14 single-level, 3 two-level fusions) with an 8-month average follow-up.
- Average hospital stay of 2 days, excluding complications.
- Two conversions to open procedures, two donor site infections, one endplate fracture requiring decompression.
Conclusions:
- Laparoscopic interbody fusion is effective and advantageous once mastered.
- Associated with a significant learning curve.
- Operative time and hospital stay are expected to decrease with experience and instrumentation development.