Four Complications Associated with Lateral and Oblique Fusion Treatable with Endoscopic Spine Surgery: Technical Note and Case Series

Abstract

Background The lateral fusion procedure is a newer minimally invasive approach to indirectly decompressing and fusing a lumbar motion segment. As with many new procedures, new thoughtful approaches to recognizing and treating the complications of these procedures need to be developed. Objectives Here we describe our experience with transforaminal endoscopic decompression for complications of lateral and oblique lumbar fusion. Study design Retrospective case review. Setting This was a multicenter study that took place in an academic hospital, community hospital, and ambulatory surgery center. Methods An endoscopic treatment technique for 4 types of complications associated with lateral and oblique fusion is presented. We retrospectively reviewed cases at 3 centers in 2 countries of patients who underwent transforaminal endoscopic surgery for the treatment of lateral fusion complications in a 4-year period with a minimum follow-up of 1 year. Results A preliminary series of 4 patients with an average age of 74.8 years (range, 69-82 years) who underwent transforaminal endoscopic procedures at the level of their lateral and oblique lumbar fusions between 2014 and 2018 is presented. Disc herniations, heterotopic bone formation, endplate fracture, and nerve root impingement by the interbody device were all treated endoscopically. Limitations Small case series evaluated retrospectively with 1-year follow-up. Conclusions Transforaminal endoscopic surgery is a useful minimally invasive surgical technique to treat several complications associated with lateral and oblique lumbar interbody fusion procedures.