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J Neurol Surg A Cent Eur Neurosurg 2024; 85(01): 039-047
DOI: 10.1055/a-1994-7857
Original Article

Is Full-Endoscopic Transforaminal Lumbar Interbody Fusion Superior to Open Transforaminal Lumbar Interbody Fusion for Single-Level Degenerative Lumbar Spondylolisthesis? A Retrospective Study

Jianjian Yin   *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China
,
Xijia Jiang   *
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China
,
Nanwei Xu
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China
,
Luming Nong 
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China
,
Yuqing Jiang
1   Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital with Nanjing Medical University, Changzhou, People's Republic of China
› Author Affiliations Funding The research was supported by the general project of Jiangsu Provincial Department of Health (H2019025); Six Talent Peaks Project, Jiangsu Provincial Finance Department (WSW-186); and Jiangsu Provincial Social Development Project (BE2020650).
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Abstract

Background In this study, we evaluate the clinical efficacy and safety of full-endoscopic transforaminal lumbar interbody fusion (TLIF) for treatment of single-level lumbar degenerative spondylolisthesis.

Methods Fifty-three patients were divided into two groups according to the surgical techniques: Full endoscopic (Endo)-TLIF (n = 25) and TLIF (n = 28). Clinical efficacy was evaluated pre- and postoperatively. The operation time, operative blood loss, postoperative amount of serum creatine phosphokinase (CPK), postoperative drainage volume, postoperative hospital stay time, total cost, and operative complications were also recorded.

Results Compared with the TLIF group, the Endo-TLIF group had similar intraoperative blood loss, less postoperative increased CPK, less postoperative drainage volume, and shorter postoperative hospital stay, but longer operative time and higher total cost. The postoperative visual analog scale (VAS) scores of back and leg pain and Oswestry Disability Index (ODI) scores significantly improved compared with the preoperative scores in both two groups; more significant improvement of postoperative VAS scores of back pain and ODI scores were shown in the Endo-TLIF group at the 1-month follow-up (p < 0.05). No difference was found in the intervertebral fusion rate between the two groups.

Conclusion The Endo-TLIF has similar clinical effect compared with the TLIF for the treatment of lumbar degenerative spondylolisthesis. It also has many surgical advantages such as less muscle trauma, less postoperative back pain, and fast functional recovery of the patient. However, steep learning curve, longer operative time, and higher total cost may be the disadvantages that limit this technique. Also, the Endo-TLIF treatment of patients with bilateral lateral recess stenosis is considered a relative contraindication.

Keywords

degenerative spondylolisthesis - full-endoscopic transforaminal lumbar interbody fusion - TLIF - percutaneous pedicle screw

Author Contributions

L.M.N. and Y.Q.J. were responsible for conception and design of the study, and final approval of the version to be published. Acquisition of data, analysis, and interpretation of data were performed by J.J.Y. and X.J.J. Drafting and revision of the article were done by N.W.X. All the authors read and approved the final manuscript.


Availability of Data and Materials

The datasets supporting the conclusions of this article are included within the article. The raw data can be requested from the corresponding author upon reasonable request.


Ethics Approval and Consent to Participate

This study was approved by the Affiliated Changzhou No. 2 People's Hospital with Nanjing Medical University Institutional Review Board (IRB), and due to the retrospective nature of the study, informed consent is waived by the institute review board under ethics approval and consent to participate section. All procedures performed in this study were in accordance with the ethical standards of the national research committee.


* Co-first authors: Jianjian Yin and Xijia Jiang.




Publication History

Received: 21 January 2022

Accepted: 05 December 2022

Accepted Manuscript online:
08 December 2022

Article published online:
31 July 2023

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  • Reference

  • 1 Bydon M, Alvi MA, Goyal A. Degenerative lumbar spondylolisthesis: definition, natural history, conservative management, and surgical treatment. Neurosurg Clin N Am 2019; 30 (03) 299-304
    CrossrefPubMedGoogle Scholar
  • 2 Kalichman L, Hunter DJ. Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J 2008; 17 (03) 327-335
    CrossrefPubMedGoogle Scholar
  • 3 Longo UG, Loppini M, Romeo G, Maffulli N, Denaro V. Evidence-based surgical management of spondylolisthesis: reduction or arthrodesis in situ. J Bone Joint Surg Am 2014; 96 (01) 53-58
    CrossrefPubMedGoogle Scholar
  • 4 Hibbs RA. A further consideration of an operation for Pott's disease of the spine: with report of cases from the service of the New York Orthopaedic Hospital. Ann Surg 1912; 55 (05) 682-688
    CrossrefPubMedGoogle Scholar
  • 5 Chan AK, Bisson EF, Bydon M. et al. A comparison of minimally invasive and open transforaminal lumbar interbody fusion for grade 1 degenerative lumbar spondylolisthesis: an analysis of the prospective quality outcomes database. Neurosurgery 2020; 87 (03) 555-562
    CrossrefPubMedGoogle Scholar
  • 6 de Kunder SL, van Kuijk SMJ, Rijkers K. et al. Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis. Spine J 2017; 17 (11) 1712-1721
    CrossrefPubMedGoogle Scholar
  • 7 Sato J, Ohtori S, Orita S. et al. Radiographic evaluation of indirect decompression of mini-open anterior retroperitoneal lumbar interbody fusion: oblique lateral interbody fusion for degenerated lumbar spondylolisthesis. Eur Spine J 2017; 26 (03) 671-678
    CrossrefPubMedGoogle Scholar
  • 8 Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg 2015; 1 (01) 2-18
    CrossrefPubMedGoogle Scholar
  • 9 Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine 2008; 33 (09) 931-939
    CrossrefPubMedGoogle Scholar
  • 10 Kim HS, Paudel B, Jang JS. et al. Percutaneous full endoscopic bilateral lumbar decompression of spinal stenosis through uniportal-contralateral approach: techniques and preliminary results. World Neurosurg 2017; 103: 201-209
    CrossrefPubMedGoogle Scholar
  • 11 Wu W, Yang S, Diao W. et al. Analysis of clinical efficacy of endo-LIF in the treatment of single-segment lumbar degenerative diseases. J Clin Neurosci 2020; 71: 51-57
    CrossrefPubMedGoogle Scholar
  • 12 Schizas C, Theumann N, Burn A. et al. Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine 2010; 35 (21) 1919-1924
    CrossrefPubMedGoogle Scholar
  • 13 Ferrero E, Guigui P. Current trends in the management of degenerative lumbar spondylolisthesis. EFORT Open Rev 2018; 3 (05) 192-199
    CrossrefPubMedGoogle Scholar
  • 14 Mujagic E, Marti WR, Coslovsky M. et al. Associations of hospital length of stay with surgical site infections. World J Surg 2018; 42 (12) 3888-3896
    CrossrefPubMedGoogle Scholar
  • 15 Yörükoğlu AG, Göker B, Tahta A. et al. Fully endoscopic interlaminar and transforaminal lumbar discectomy: analysis of 47 complications encountered in a series of 835 patients. Neurocirugia (Astur) 2017; 28 (05) 235-241
    CrossrefPubMedGoogle Scholar
  • 16 Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Am J Infect Control 1999; 27 (02) 97-132 , quiz 133–134, discussion 96
    CrossrefPubMedGoogle Scholar
  • 17 Zhao XB, Ma HJ, Geng B, Zhou HG, Xia YY. Early clinical evaluation of percutaneous full-endoscopic transforaminal lumbar interbody fusion with pedicle screw insertion for treating degenerative lumbar spinal stenosis. Orthop Surg 2021; 13 (01) 328-337
    CrossrefPubMedGoogle Scholar
  • 18 Zhang H, Zhou C, Wang C. et al. Percutaneous endoscopic transforaminal lumbar interbody fusion: technique note and comparison of early outcomes with minimally invasive transforaminal lumbar interbody fusion for lumbar spondylolisthesis. Int J Gen Med 2021; 14: 549-558
    CrossrefPubMedGoogle Scholar
  • 19 Ghiasi MS, Arjmand N, Shirazi-Adl A. et al. Cross-sectional area of human trunk paraspinal muscles before and after posterior lumbar surgery using magnetic resonance imaging. Eur Spine J 2016; 25 (03) 774-782
    CrossrefPubMedGoogle Scholar
  • 20 Pourtaheri S, Issa K, Lord E. et al. Paraspinal muscle atrophy after lumbar spine surgery. Orthopedics 2016; 39 (02) e209-e214
    CrossrefPubMedGoogle Scholar
  • 21 Akçakaya MO, Yörükoğlu AG, Aydoseli A. et al. Serum creatine phosphokinase levels as an indicator of muscle injury following lumbar disc surgery: comparison of fully endoscopic discectomy and microdiscectomy. Clin Neurol Neurosurg 2016; 145: 74-78
    CrossrefPubMedGoogle Scholar
  • 22 Shimizu T, Fujibayashi S, Otsuki B, Murata K, Matsuda S. Indirect decompression with lateral interbody fusion for severe degenerative lumbar spinal stenosis: minimum 1-year MRI follow-up. J Neurosurg Spine 2020; 33 (01) 27-34
    CrossrefPubMedGoogle Scholar
  • 23 Xie TH, Zeng JC, Li ZH. et al. Complications of lumbar disc herniation following full-endoscopic interlaminar lumbar discectomy: a large, single-center, retrospective study. Pain Physician 2017; 20 (03) E379-E387
    PubMedGoogle Scholar
  • 24 De Rojas JO, Syre P, Welch WC. Regional anesthesia versus general anesthesia for surgery on the lumbar spine: a review of the modern literature. Clin Neurol Neurosurg 2014; 119: 39-43
    CrossrefPubMedGoogle Scholar
  • 25 Hua W, Wang B, Ke W. et al. Comparison of clinical outcomes following lumbar endoscopic unilateral laminotomy bilateral decompression and minimally invasive transforaminal lumbar interbody fusion for one-level lumbar spinal stenosis with degenerative spondylolisthesis. Front Surg 2021; 7: 596327
    CrossrefPubMedGoogle Scholar
  • 26 Zhao XB, Ma HJ, Geng B, Zhou HG, Xia YY. Percutaneous endoscopic unilateral laminotomy and bilateral decompression for lumbar spinal stenosis. Orthop Surg 2021; 13 (02) 641-650
    CrossrefPubMedGoogle Scholar