Endoscopy-assisted posterior lumbar interbody fusion in a single segment

Abstract

Posterior lumbar interbody fusion (PLIF) has been routinely performed for the treatment of lumbar segmental lesions. However, traditional PLIF procedures can result in a variety of approach-related morbidities. The purpose of this study was to determine the efficacy of endoscopy-assisted PLIF in lumbar arthrodesis. From July 2005 to May 2007, a total of 56 patients underwent PLIF, including 24 endoscopy-assisted operations (endoscopic group) and 32 traditional open operations (open group). The perioperative data, clinical outcomes and radiographic results were compared. The intraoperative bleeding volume, postoperative drainage volume, intraoperative and postoperative allogeneic blood transfusion volumes, values for C-reactive protein and erythrocyte sedimentation rate on postoperative day 3 and postoperative hospitalization days were decreased in the endoscopic group (p<0.05), while the operative time was longer than that of the open group (p=0.026). According to the Visual Analog Scale for pain, the postoperative low back pain score in the endoscopic group was lower than that observed in the open group (p<0.05). In the endoscopic group, the excellent and good outcome rate was 87.5%, the incidence of complications was 8.3%, and the intervertebral fusion rate was 100%. There were no significant differences for these outcomes when compared with the open group (p>0.05). Endoscopy-assisted PLIF can achieve a clinical efficacy similar to that of traditional open operations while minimizing destruction to adjacent tissues. This technique is safe and is characterized by less bleeding, less tissue trauma, decreased postoperative pain, rapid recovery, and a shorter postoperative hospital stay.