Percutaneous transforaminal endoscopic decompression and cageless percutaneous bone graft transforaminal lumbar interbody fusion: A feasibility study

Abstract

INTRODUCTION: In the quest for better alternatives for open transforaminal lumbar interbody fusion (TLIF), minimally invasive surgery-TLIF (MIS-TLIF) has evolved, and feasibility studies of transforaminal endoscopic fusion are also getting reported in western literature. However, the cost of instrumented expandable cage may make it non-feasible for Indian setup whenever it will be commercially available. METHODS: This is a retrospective study of 13 patients of single-level percutaneous transforaminal endoscopic decompression and cageless percutaneous bone graft TLIF with percutaneous pedicle screw fixation under combined local with epidural anesthesia. The results of all patients as measured by validated tools of visual analogue score-Back and Leg, Oswestry Disability Index, patient satisfaction index, and fusion. The operating time, Estimated Blood Loss, Length of hospital stay and tolerance of patient for procedure was also scored. RESULTS: All the outcome measures were significant (P < 0.05) and fusion achieved in all with a mean follow-up period was 39 ± 6.36 months. Operating room time was 250.23 ± 52.90 min (187–327). Postoperative LOH hospital stay was 29.92 ± 4.94 h (24–39). The tolerance score was 2.30 ± 0.85 (1–3). One superficial bone graft site infection resolved with antibiotics. CONCLUSION: It not appealing to be recommendable to general population inspite of it being low cost and with negligible complications. Further research and engineered tools are needed to reduce the operating time.