Background: Biportal endoscopic transforaminal lumbar interbody fusion (BE-TLIF) is a minimally invasive surgical technique for treating degenerative lumbar spine conditions. It offers advantages such as reduced soft tissue trauma and lower infection rates, but certain technical aspects may be challenging. The current study aims to identify strategies to enhance the fusion rate in BE-TLIF by addressing these specific challenges.
Methods: A literature review was conducted on techniques to improve fusion rates in BE-TLIF.
Results: The review suggests that lateral-based portals supplemented with medial portals allowed for safe insertion of interbody cages with large footprint. Direct visualization of the disc space with a 30° endoscope assisted with better disc space preparation. Facetectomies performed with osteotomes, rather than burrs, ensured maximum retrieval of autologous bone graft. Utilizing bone morphogenetic proteins with sustained release carriers such as hydroxyapatite can be useful to increase fusion rates of BE-TLIF.
Conclusions: To our knowledge, the current literature is the first comprehensive review of strategies to enhance fusion rates in BE-TLIF. The proposed techniques and biological adjuncts are effective means to address key challenges associated with the procedure, and such strategies would potentially shorten the learning curve and improve clinical outcomes. Further clinical studies are required to validate these findings and establish standardized protocols.
Clinical Relevance: These findings provide practical solutions to overcome common challenges in BE-TLIF. The suggested techniques would reduce the incidence of pseudarthrosis, improve patient outcomes, and ultimately offer a safer and more reliable option for lumbar interbody fusion patients.
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http://dx.doi.org/10.14444/8648 | DOI Listing |
J Neurosurg Spine
December 2024
Departments of1Neurosurgery and.
Objective: Patients undergoing anterior/posterior lumbar fusion surgery can undergo either a single-stage or multistage operation, depending on surgeon preference. The goal of this study was to assess different patient outcomes between single-stage and multistage lumbar fusion procedures in a multicenter setting.
Methods: The Michigan Spine Surgery Improvement Collaborative database was queried for anterior/posterior lumbar fusion surgeries between July 2018 and January 2022.
BMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, Hangzhou First People's Hospital, Hangzhou, 310006, China.
Background: This meta-analysis was performed to comprehensively evaluate the efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) versus uniportal endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for the treatment of lumbar degenerative diseases.
Methods: We electronically searched PubMed, Embase, Scopus, Web of Science, the Cochrane Library, the Wanfang Database, and China National Knowledge Infrastructure to identify controlled clinical studies on the efficacy and safety of UBE-TLIF and Endo-TLIF for lumbar degenerative diseases from database establishment to December 2023. Two researchers screened the literature, extracted data, and evaluated the risk of bias of the included studies.
J Orthop Surg Res
December 2024
The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.
Background Context: As lumbar degenerative diseases become more prevalent in an aging population, there is an increasing demand for surgical interventions, such as posterior lumbar interbody fusion (PLIF). However, cage subsidence (CS), observed in 23.9-54% of cases postoperatively, remains a significant complication.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Department of Orthopedic Spine Surgery, Yan'an Hospital Affiliated to Kunming Medical University, 245, East of Renmin Road, 650051, Kunming, Yunnan, P.R. China.
Background: Degenerative lumbar spondylolisthesis (DLS) with lumbar spinal stenosis (LSS) is a common condition resulting in substantial lower back pain and disability. Surgical intervention is recommended only when conservative treatment fails. This study compared UBE-TLIF and MIS-TLIF regarding clinical outcomes and fusion rates in patients with single-segment DLS with LSS.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, The Second Affiliated Hospital of Soochow University, No.1055 Sanxiang Road, Gusu District, Suzhou, Jiangsu, 215004, China.
Background: Hidden blood loss (HBL) is often ignored unilateral biportal endoscopic interbody fusion surgery (ULIF). We investigated the amount and influencing factors of HBL in ULIF surgery in this study.
Methods: From October 2020 to November 2023, 100 patients' clinical and radiological data were retrospectively analyzed.
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