Sang-Ho Lee, M.D., Ph.D, .Won-Chul Choi, M.D.,
Study
design: 5 patients treated by percutaneous
endoscopic lumbar interbody fusion were reviewed.
Summary
of background data: In patient with lower
back pain due to segmental instability conventional posterior interbody fusion
violated lamina, facet joint ligament, soft tissue. Percutaneous interbody
fusion in posterolateral approach was evaluated as minimally invasive fusion
technique.
Objectives:
To represent posterolateral percutaneous interbody fusion technique and a successful
outcome and fusion state in follow up time.
Method:
5 patients with lower back pain and radiating leg pain due to degenerative disc
disease (DDD), Grade I lytic spondylolisthesis underwent posterolateral
percutaneous interbody fusion with expandable holder and pedicle screw
augmentation.
One patient was male and 4 patients were
female. Mean Follow-up interval was 13.2 months.
A biportal percutaneous approach was done
with a 7.5mm working tube in diameter. The endplate was scratched by a special curette
and a eccentrical drill.
5mm in diameter expandable holder in
closed state can expand to 11, 13.15 mm in diameter. In 3 cases, percutaneous
pedicle screw fixation was done.
All surgical procedures were performed
under C-arm fluoroscopic control and regional anesthesia via epidural catheter.
Result:
All patients had symptomatic improvement as determined by visual analogue
scale. In radiological study flexion/extension x-ray showed solid fusion.
Patients were tolerable and had no
complication in surgical procedures.
Conclusion:
Posterolateral percutaneous interbody fusion method with expandable holder
and/or pedicle screw augmentation was very safe and minimally invasive
technique. Because of percutaneous approach and regional anesthesia patients
were comfortable and fast functional recovery perioperatively. This Surgical
method is a promising alternative to open fusion surgery.