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Laparoscopic assisted spine surgery
P F Heini1, L Krähenbühl, O Schwarzenbach
1Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland.
Background:
Evaluation of the technical aspects and clinical outcome of laparoscopic assisted interbody fusion (LAIF) using the BAK technique.
Method:
17 patients with chronic low back pain due to degenerative disc disease at L5-S1 and L4-L5 were treated with LAIF using the BAK technique. Surgical time, blood loss and intraoperative problems were assessed. The short-term clinical and radiological outcome was measured.
Results:
The technical part of the procedure depends on a learning curve. However, in collaboration with a laparoscopic surgeon no complications related to the technique occurred. The limits of the technique are due to the anatomical situation at the L4-L5 level. 14/17 patients had an improvement in their lower back pain.
Conclusion:
The technique of LAIF is demanding. The L5-S1 level can be addressed with ease; however, transabdominal fusion of L4-L5 is not recommended. Patient selection remains the keystone. LAIF is the least invasive measure in order to stabilize and fuse a motion segment.