Lumbar percutaneous endoscopic interbody fusion

Area of Science:

• Minimally Invasive Spine Surgery
• Orthopedic Surgery
• Neurosurgery

Background:

• Percutaneous endoscopic techniques have evolved since 1982 for lumbar disc herniations.
• Early adoption of percutaneous intervertebral bone grafting highlighted the need for improved techniques.
• Development of specialized instruments like the end plate cutter and external pedicle fixation device addressed these needs.

Purpose of the Study:

• To evaluate the efficacy of a standardized percutaneous endoscopic technique for lumbar contained disc herniations.
• To assess the rate of bony interbody consolidation and functional outcomes.
• To determine the suitability of this minimally invasive approach for specific lumbar dysfunctions.

Main Methods:

• Selective posterior subligamentary decompression using percutaneous endoscopic control.
• Percutaneous preparation of vertebral end plates with an eccentric abrasive cutter.
• Use of external pedicle fixation for stabilization.
• Percutaneous autologous bone interposition for interbody fusion.

Main Results:

• Bony interbody consolidation achieved in 30 out of 37 patients (81%) with a mean follow-up of 33 months.
• The technique eliminated the need for blood transfusions.
• Functional rehabilitation was facilitated due to the limited percutaneous approach.

Conclusions:

• Standardized percutaneous endoscopic surgery is effective for monosegmental lumbar disc herniations without need for decompression.
• The technique promotes optimal bony interbody consolidation and allows for early functional recovery.
• Minimally invasive spine surgery offers a viable alternative with reduced patient morbidity.