{"title":"Biportal Endoscopic Transforaminal Interbody Fusion: Comparing Primary Versus Revision Cases.","authors":"Ju-Eun Kim, Eugene J Park, Daniel K Park","doi":"10.5435/JAAOS-D-23-01031","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The safety and efficacy of biportal endoscopic lumbar interbody fusion (BELIF) has been supported by many articles. Advantages include earlier rehabilitation and equal or superior fusion rates compared with other lumbar interbody fusion techniques.</p><p><strong>Purpose: </strong>To compare the clinical and radiological outcomes of primary and revision biportal endoscopic interbody fusion.</p><p><strong>Methods: </strong>Seventy-two consecutive patients who underwent primary and revision BELIF and had at least 2-year follow-up were investigated. Clinical outcomes, including Oswestry Disability Index, the visual analog system (VAS), MacNab's criteria, surgical time, and length of hospital stay, were recorded. Radiological outcome was assessed by CT and graded according to Bridwell system.</p><p><strong>Results: </strong>No notable difference was found in preoperative baselines between the groups. Both groups demonstrated similar clinical improvement in VAS, Oswestry Disability Index, and MacNab criteria. Durotomies were more common in the revision setting (4/33 vs. 0/39 in primary), and surgical time was statistically longer (121.4 ± 21.5 minutes primary versus 179 ± 23.7 minutes revision; P < 0.001). However, no difference was observed in fusion rates at all times points graded by CT scan (94.87% vs. 93.93% primary versus revision at the final follow-up, P = 0.51).</p><p><strong>Conclusion: </strong>Revision BELIF demonstrate similar clinical and radiographic outcomes compared with primary BELIF, yet surgical time and durotomy risks are increased.</p><p><strong>Study design: </strong>Retrospective study.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Orthopaedic Surgeons","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5435/JAAOS-D-23-01031","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The safety and efficacy of biportal endoscopic lumbar interbody fusion (BELIF) has been supported by many articles. Advantages include earlier rehabilitation and equal or superior fusion rates compared with other lumbar interbody fusion techniques.
Purpose: To compare the clinical and radiological outcomes of primary and revision biportal endoscopic interbody fusion.
Methods: Seventy-two consecutive patients who underwent primary and revision BELIF and had at least 2-year follow-up were investigated. Clinical outcomes, including Oswestry Disability Index, the visual analog system (VAS), MacNab's criteria, surgical time, and length of hospital stay, were recorded. Radiological outcome was assessed by CT and graded according to Bridwell system.
Results: No notable difference was found in preoperative baselines between the groups. Both groups demonstrated similar clinical improvement in VAS, Oswestry Disability Index, and MacNab criteria. Durotomies were more common in the revision setting (4/33 vs. 0/39 in primary), and surgical time was statistically longer (121.4 ± 21.5 minutes primary versus 179 ± 23.7 minutes revision; P < 0.001). However, no difference was observed in fusion rates at all times points graded by CT scan (94.87% vs. 93.93% primary versus revision at the final follow-up, P = 0.51).
Conclusion: Revision BELIF demonstrate similar clinical and radiographic outcomes compared with primary BELIF, yet surgical time and durotomy risks are increased.
期刊介绍:
The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues.
Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.