[Combined endoscopic and percutaneous technique to treat lumbar spondylolisthesis - technical note].

Abstract

Background and purpose: The surgery of spondylolisthesis or vertebral slippage aims to treat segmental instability and decompress nerve structures. Because of the complications/consequences of open surgical techniques, a demand emerged from both patients and surgeons to develop minimally invasive techniques such as endoscopic methods. The purpose of this article is to present endoscopic interbody fusion technique that is a safe and effective alternative in the treatment of patients with vertebral slippage.

Methods: The surgery is performed under general anesthesia. Under aseptic circumstances, two 1,5-2 centimeters paramedian incisions are used to introduce endoscopic instruments on the symptomatic side.Continuous irrigation is used during the surgery. Yellow ligament can be removed both ipsilateral and contralateral under endoscopic visualization with the decompression of nerve roots at the same time. After removing the intervertebral disc, a cage is implanted through the working channel to which enough space is provided with sufficient bony decompression. The screws and rods are placed with standard percutaneous technique under continuous fluoroscopy guidance.

Results: The endoscopic interbody fusion technique could reduce the time of hospital stay, intraoperative blood loss, postoperative pain and recovery time in total. Compared to open surgeries, the incidence of postoperative adjacent segment syndrome can also be reduced. All of aesthetic result, decreased rehabilitation time and faster return to work increase the satisfaction of patients.

Conclusion: The endoscopic interbody fusion technique is a safe and sufficient method in the treatment of vertebral slippage with all advantages of minimally invasive techniques.