NDLI: The feasibility for a novel minimally invasive surgery–percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for the treatment of lumbar degenerative diseases: a cadaveric experiment

Content Provider	Springer Nature : BioMed Central
Author	Yin, Peng Zhang, Yaoshen Pan, Aixing Ding, Yi Zhang, Liming Xu, Chunyang Yang, Jincai Hai, Yong
Abstract	Background The objective of the study was to evaluate our innovative percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for the treatment of lumbar degenerative diseases. Methods Two fresh-frozen human cadavers with soft tissues were donated for the experiment. Both cadavers had no history of previous spine surgery. The PE-TLIF surgery was performed on 3 levels (L4-5 of the first one, and L3-4, L4-5 of the second one) in October 2015. The PE-TLIF technique mainly included the following aspects: primary guide pins and a specially designed superior articular process (SAP) guide insertion, working channel setup, endoscopic decompression and fusion, and pedicle screw implantation and fixation. Under the surveillance of C-arm fluoroscope, four primary guide pins were inserted. The inferior primary guide in the hypothetically symptomatic side was confirmed as the first guide pin. At the end of the first guide pin, the specially designed SAP guide was installed. The secondary guide pin was inserted in the SAP via self-designed SAP guide. Under the protection cannula, part of the superior articular process was removed by oriented SAP resection device, so the working channel was smoothly put through the Kambin’s triangle. The endoscope was inserted close to the exiting nerve root. Rotation of the working channel kept the nerve root out of it. Results Three levels of PE-TLIF were successfully performed in two cadavers. Self-designed SAP guide made the secondary guide pin inserting the SAP accurately. Decompression was adequate and the traversing nerve root was relieved. Three aimed intervertebral levels are implanted with two 7-mm-high PEEK cages and one expandable cage. The expandable cage could be adjusted from 8 mm to 13 mm. Surgical incisions included four 15 mm incisions for percutaneous screw fixation and one 12 mm incision for working channel. There was no nerve injury during the operations. Conclusions Our present results showed that the novel minimally invasive surgery PE-TLIF was feasible for the treatment of lumbar degenerative diseases.
Related Links	https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-020-01930-0.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13018-020-01930-0
Journal	Journal of Orthopaedic Surgery and Research
Issue Number	1
Volume Number	15
Language	English
Publisher	BioMed Central
Publisher Date	2020-09-08
Access Restriction	Open
Subject Keyword	Orthopedics Surgical Orthopedics Minimally invasive surgery Percutaneous Spinal endoscope Transforaminal lumbar interbody fusion Lumbar degenerative diseases
Content Type	Text
Resource Type	Article
Subject	Surgery Orthopedics and Sports Medicine
Journal Impact Factor	2.8/2023
5-Year Journal Impact Factor	3/2023

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