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Feasibility of Endoscopic Transforaminal Lumbar Interbody Fusion

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Technical Advances in Minimally Invasive Spine Surgery

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Abstract

The endoscopic transforaminal lumbar interbody fusion is a minimally invasive procedure that has the advantage of faster recovery times and less tissue dissection. Bone and supportive soft tissues of the spine can be preserved. The Kambin’s triangle, which originally served as a guide for an endoscopic lumbar discectomy, can be applied to an interbody fusion. The anatomical zone described by Kambin, along with tools and hardware designed for the endoscopic approach, make it a feasible surgery that can be performed safely.

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References

  1. Ahn Y, Lee S-H, Park W-M, Lee H-Y, Shin S-W, Kang H-Y. Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine (Phila Pa 1976). 2004;29(16):E326–32.

    Article  Google Scholar 

  2. Ahn Y, Oh H-K, Kim H, Lee S-H, Lee H-N. Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery. 2014;75(2):124–33.

    Article  Google Scholar 

  3. Musacchio M, Patel N, Bagan B, Deutsch H, Vaccaro AR, Ratliff J. Minimally invasive lumbar laminectomy via a dual-tube technique: evaluation in a cadaver model. Surg Neurol. 2007;67(4):348–52.

    Article  Google Scholar 

  4. Heo DH, Son SK, Eum JH, Park CK. Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurg Focus. 2017;43(2):E8.

    Article  Google Scholar 

  5. Wang MY, Grossman J. Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up. Neurosurg Focus. 2016;40(2):E13.

    Article  Google Scholar 

  6. Sakane M. Anatomical relationship between Kambin’s triangle and exiting nerve root. Mini-Invasive Surg. 2017;1(1):99–102.

    Google Scholar 

  7. Yang J, Liu C, Hai Y, Yin P, Zhou L, Zhang Y, et al. Percutaneous endoscopic transforaminal lumbar interbody fusion for the treatment of lumbar spinal stenosis: preliminary report of seven cases with 12-month follow-up. Biomed Res Int. 2019;2019

    Google Scholar 

  8. Choi I, Ahn J-O, So W-S, Lee S, Choi I-J, Kim H. Exiting root injury in transforaminal endoscopic discectomy: preoperative image considerations for safety. Eur Spine J. 2013;22(11):2481–7.

    Article  Google Scholar 

  9. Ahn Y, Youn MS, Heo DH. Endoscopic transforaminal lumbar interbody fusion: a comprehensive review. Expert Rev Med Devices. 2019;16(5):373–80.

    Article  CAS  Google Scholar 

  10. Kambin P, Casey K, O’Brien E, Zhou L. Transforaminal arthroscopic decompression of lateral recess stenosis. J Neurosurg. 1996;84(3):462–7.

    Article  CAS  Google Scholar 

  11. Sairyo K, Sakai T, Higashino K, Inoue M, Yasui N, Dezawa A. Complications of endoscopic lumbar decompression surgery. Minim Invasive Neurosurg. 2010;53(04):175–8.

    Article  CAS  Google Scholar 

  12. Sairyo K, Matsuura T, Higashino K, Sakai T, Takata Y, Goda Y, et al. Surgery related complications in percutaneous endoscopic lumbar discectomy under local anesthesia. J Med Investig. 2014;61(3–4):264–9.

    Article  Google Scholar 

  13. Epstein NE. More nerve root injuries occur with minimally invasive lumbar surgery, especially extreme lateral interbody fusion: a review. Surg Neurol Int. 2016;7(Suppl 3):S83.

    Article  Google Scholar 

  14. Ahn Y, Jang I-T, Kim W-K. Transforaminal percutaneous endoscopic lumbar discectomy for very high-grade migrated disc herniation. Clin Neurol Neurosurg. 2016;147:11–7.

    Article  Google Scholar 

  15. Yeung A, Lewandrowski K-U. Five-year clinical outcomes with endoscopic transforaminal foraminoplasty for symptomatic degenerative conditions of the lumbar spine: a comparative study of inside-out versus outside-in techniques. J Spine Surg. 2020;6(Suppl 1):S66.

    Article  Google Scholar 

  16. Telfeian AE, Shen J, Ali R, Oyelese A, Fridley J, Gokaslan ZL. Incidence and implications of incidental durotomy in transforaminal endoscopic spine surgery: case series. World Neurosurg. 2020;134:e951–5.

    Article  Google Scholar 

  17. Hsu H-T, Chang S-J, Yang SS, Chai CL. Learning curve of full-endoscopic lumbar discectomy. Eur Spine J. 2013;22(4):727–33.

    Article  Google Scholar 

  18. Lee JC, Jang H-D, Shin B-J. Learning curve and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion: our experience in 86 consecutive cases. Spine (Phila Pa 1976). 2012;37(18):1548–57.

    Article  Google Scholar 

  19. Kambin P. Posterolateral percutaneous lumbar discectomy and decompression. Arthrosc Microdiscectomy Minimal Interv Spinal Surg. 1991;

    Google Scholar 

  20. Kambin P, Sampson S. Posterolateral percutaneous suction-excision of herniated lumbar intervertebral discs. Report of interim results. Clin Orthop Relat Res 1986;(207):37–43.

    Google Scholar 

  21. Kambin P, Gellman H. Percutaneous lateral discectomy of the lumbar spine a preliminary report. Clin Orthop Relat Res. 1983;174:127–32.

    Article  Google Scholar 

  22. Kambin P, Brager MD. Percutaneous posterolateral discectomy. Anatomy and mechanism. Clin Orthop Relat Res 1987;(223):145–54.

    Google Scholar 

  23. Tumialán LM, Madhavan K, Godzik J, Wang MY. The history of and controversy over Kambin’s triangle: a historical analysis of the lumbar transforaminal corridor for endoscopic and surgical approaches. World Neurosurg. 2019;123:402–8.

    Article  Google Scholar 

  24. Abe T, Sakane M, Harabayashi H, Noguchi H, Tsukada A, Ochiai N. Comparison of clinical outcomes of percutaneous endoscopic discectomy and open surgery for lumbar disc herniation. J Japan Spine Res Soc. 2009;20(3):653–5.

    Google Scholar 

  25. Hoshide R, Feldman E, Taylor W. Cadaveric analysis of the Kambin’s triangle. Cureus. 2016;8(2)

    Google Scholar 

  26. Sinkemani A, Hong X, Gao Z-X, Zhuang S-Y, Jiang Z-L, Zhang S-D, et al. Outcomes of microendoscopic discectomy and percutaneous transforaminal endoscopic discectomy for the treatment of lumbar disc herniation: a comparative retrospective study. Asian Spine J. 2015;9(6):833.

    Article  Google Scholar 

  27. Pairaiturkar PP, Sudame OS, Pophale CS. Evaluation of dimensions of Kambin’s triangle to calculate maximum permissible cannula diameter for percutaneous endoscopic lumbar discectomy: a 3-dimensional magnetic resonance imaging based study. J Korean Neurosurg Soc. 2019;62(4):414.

    Article  Google Scholar 

  28. Hardenbrook M, Lombardo S, Wilson MC, Telfeian AE. The anatomic rationale for transforaminal endoscopic interbody fusion: a cadaveric analysis. Neurosurg Focus. 2016;40(2):E12.

    Article  Google Scholar 

  29. Kambin P. Percutaneous lumbar discectomy: current practice. Surg Rounds Orthop. 1988;2:31–5.

    Google Scholar 

  30. Lertudomphonwanit T, Keorochana G, Kraiwattanapong C, Chanplakorn P, Leelapattana P, Wajanavisit W. Anatomic considerations of intervertebral disc perspective in lumbar posterolateral approach via Kambin’s triangle: cadaveric study. Asian Spine J. 2016;10(5):821.

    Article  Google Scholar 

  31. Zhang L, Yang J, Hai Y, Yin P, Ding Y, Xu C, et al. Relationship of the exiting nerve root and superior articular process in Kambin’s triangle: assessment of lumbar anatomy using cadavers and computed tomography imaging. World Neurosurg. 2020;

    Google Scholar 

  32. Basil G, Wang MY. Technical considerations of endoscopic Kambin’s triangle lumbar interbody fusion. World Neurosurg. 2020;

    Google Scholar 

  33. Lee W, Park J-Y, Kim KH, Kuh SU, Chin DK, Kim KS, et al. Minimally invasive transforaminal lumbar interbody fusion in multilevel: comparison with conventional transforaminal interbody fusion. World Neurosurg. 2016;85:236–43.

    Article  Google Scholar 

  34. Li Z, Hou S, Shang W, Cao Z, Zhao H. Percutaneous lumbar foraminoplasty and percutaneous endoscopic lumbar decompression for lateral recess stenosis through transforaminal approach: technique notes and 2 years follow-up. Clin Neurol Neurosurg. 2016;143:90–4.

    Article  Google Scholar 

  35. Sang-Ho L, Erken HY, Bae J. Percutaneous transforaminal endoscopic lumbar interbody fusion: clinical and radiological results of mean 46-month follow-up. Biomed Res Int. 2017;2017

    Google Scholar 

  36. Li X, Jin L, Lv Z, Su X, Wang K, Shen H, et al. Efficacy of percutaneous transforaminal endoscopic decompression treatment for degenerative lumbar spondylolisthesis with spinal stenosis in elderly patients. Exp Ther Med. 2020;19(2):1417–24.

    PubMed  Google Scholar 

  37. Soo ES, Sourabh C, Ho LS. Posterolateral endoscopic lumbar decompression rotate-to-retract technique for foraminal disc herniation: a technical report. Biomed Res Int. 2019;2019

    Google Scholar 

  38. McGirt MJ, Parker SL, Lerner J, Engelhart L, Knight T, Wang MY. Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients. J Neurosurg Spine. 2011;14(6):771–8.

    Article  Google Scholar 

  39. Wang J, Zhou Y, Zhang ZF, Li CQ, Zheng WJ, Liu J. Comparison of one-level minimally invasive and open transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Eur Spine J. 2010;19(10):1780–4.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Minimally Invasive and Complex Spine Fellowship Program, Temple University Hospital, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA

    Nicholas Ahye, Eric Quach, Erin Graves, Joseph Queenan & Bong-Soo Kim

Authors
  1. Nicholas Ahye
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  2. Eric Quach
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  3. Erin Graves
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  4. Joseph Queenan
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  5. Bong-Soo Kim
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Corresponding author

Correspondence to Bong-Soo Kim .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Seoul St Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea (Republic of)

    Jin-Sung Kim

  2. Department of Neurological Surgery, Weill Cornell Medicine Center for Comprehensive Spine Care, New York Presbyterian OCH SPINE, New York, NY, USA

    Roger Härtl

  3. Department of Neurosurg & Rehab Medicine, University of Miami Hospital, Miami, FL, USA

    Michael Y. Wang

  4. Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden

    Adrian Elmi-Terander

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Ahye, N., Quach, E., Graves, E., Queenan, J., Kim, BS. (2022). Feasibility of Endoscopic Transforaminal Lumbar Interbody Fusion. In: Kim, JS., Härtl, R., Wang, M.Y., Elmi-Terander, A. (eds) Technical Advances in Minimally Invasive Spine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-19-0175-1_17

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  • DOI: https://doi.org/10.1007/978-981-19-0175-1_17

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-0174-4

  • Online ISBN: 978-981-19-0175-1

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