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
