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Unilateral biportal endoscopic extreme transforaminal lumbar interbody fusion with large cage combined with endoscopic unilateral pedicle screw fixation for lumbar degenerative diseases: a technical note and preliminary effects

  • Original Article - Spine degenerative
  • Published:
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Abstract

Objective

The purpose of the study was to investigate the feasibility and preliminary effects of unilateral biportal endoscopic extreme transforaminal lumbar interbody fusion(UBE-eXTLIF) with large cage combined with endoscopic unilateral pedicle screw fixation for lumbar degenerative diseases.

Methods

Patients with lumbar degenerative diseases who received UBE-eXTLIF with large cage combined with endoscopic unilateral pedicle screw fixation from June 2022 to July 2022 were retrospectively analyzed, including 4 females and 1 males. The clinical symptoms and signs were consistent with the imaging changes. We recorded operation time, length of postoperative hospital stay, and complications. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified Macnab scale was used to evaluate the clinical efficacy at preoperative, postoperative 1 month, and the last follow-up.

Results

The operation was successfully completed in all cases. The operation time was 150–180 min, with an average of 164.60 ± 12.03 min. No serious complications such as dural tears and vascular and nerve injuries occurred during operation. All the patients got out of bed 1–3 days after surgery and were hospitalized 4–5 days after surgery, with an average of 4.20 ± 0.45 days. Preoperative VAS scores of low back pain were 6.20 ± 0.84 and respectively decreased to 2.20 ± 0.45 and 1.40 ± 0.55 at postoperative 1 month and at the last follow-up, and the difference was statistically significant (P < 0.05). Preoperative VAS scores of lower limb pain were 4.60 ± 2.61 and respectively decreased to 1.00 ± 0.71 and 0.60 ± 0.55 at postoperative 1 month and at the last follow-up, and the difference was statistically significant (P < 0.05). Preoperative ODI scores were 62.00 ± 3.16 and respectively decreased to 38.00 ± 1.41 and 32.40 ± 3.29 at postoperative 1 month and at the last follow-up, and the difference was statistically significant (P < 0.05). According to the modified Macnab criteria, the final outcome was excellent in 4 cases and good in 1 case. Five patients could return to normal activities within 3 weeks.

Conclusions

UBE-eXTLIF with large cage combined with endoscopic unilateral pedicle screw fixation can achieve excellent clinical results and may become a new minimally invasive endoscopic fusion method for lumbar degenerative diseases.

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Funding

The work was supported by grants from the Foundation of Anhui Medical University (No. 2021xkj028) and Clinical Research and Cultivation Program of the Second Hospital of Anhui Medical University (2020LCZD05).

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Author notes

  1. Dasheng Tian and Jianjun Liu contributed equally to the paper.

Authors and Affiliations

  1. Department of Orthopaedics & Spine Surgery, The Second Hospital of Anhui Medical University, Hefei, 230601, China

    Dasheng Tian, Jianjun Liu, Bin Zhu, Lei Chen & Juehua Jing

  2. Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China

    Dasheng Tian, Jianjun Liu, Bin Zhu, Lei Chen & Juehua Jing

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  1. Dasheng Tian
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  2. Jianjun Liu
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Corresponding author

Correspondence to Juehua Jing.

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The study was approved by our institutional Ethics Committee, and the informed consent was obtained from all patients.

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Tian, D., Liu, J., Zhu, B. et al. Unilateral biportal endoscopic extreme transforaminal lumbar interbody fusion with large cage combined with endoscopic unilateral pedicle screw fixation for lumbar degenerative diseases: a technical note and preliminary effects. Acta Neurochir 165, 117–123 (2023). https://doi.org/10.1007/s00701-022-05422-4

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  • DOI: https://doi.org/10.1007/s00701-022-05422-4

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