Technical note on Uniportal full endoscopic posterolateral approach transforaminal lumbar interbody fusion with reduction for grade 2 spondylolisthesis

Abstract

BackgroundUniportal Endoscopic transforaminal posterolateral approach interbody fusion (Endo-TLIF) is becoming a popular method of fusion, it harnesses the advantage of both Trans Kambin approach endoscopic tranforaminal interbody fusion and biportal transforaminal interbody fusion into one single technique. There is no description of Endo-TLIF with reduction in Grade 2 isthmic spondylolisthesis in the spine literature. ObjectiveTechnical discussion on the management of grade 2 isthmic spondylolisthesis in an elderly population by Endo-TLIF. MethodsTechnique was applied in grade 2 isthmic spondylolisthesis with the focus on uniportal endoscopic transforaminal lumbar interbody fusion; particular attention was paid in endoscopic visualization to traversing and exiting nerve root to avoid neurological complications in reducing isthmic spondylolisthesis. Direct endoscopic visualization end plate preparation helped to avoid damage of end plates and ensure adequate disc preparations. Percutaneous rod fixation with complete reduction of isthmic spondylolisthesis of L4/5 was performed. ResultsSuccessful reduction of grade 2 isthmic spondylolisthesis with good post-operative clinical outcome was observed. ConclusionFull Uniportal Endoscopic Transforaminal Interbody Fusion is a new and evolving technique with potential advantages in end plate preparation, direct visualized neural decompression and safe placement of interbody fusion device. We showed a case of a patient with a grade 2 isthmic spondylolisthesis who had successful reduction of deformity and placement of a large size interbody cage with good post-operative clinical outcome.