• Masayoshi Fukushima, Nozomu Ohtomo, Michita Noma, Yudai Kumanomido, Hiroyuki Nakarai, Keiichiro Tozawa, Yuichi Yoshida, Ryuji Sakamoto, Junya Miyahara, Masato Anno, Naohiro Kawamura, Akiro Higashikawa, Yujiro Takeshita, Hirohiko Inanami, Sakae Tanaka, and Yasushi Oshima.
• Spine Center, Toranomon Hospital, Tokyo 105-8470, Japan.
• Medicina (Kaunas). 2021 Feb 8; 57 (2).

AbstractBackground and objectives: Minimally invasive surgery has become popular for posterior lumbar interbody fusion (PLIF). Microendoscope-assisted PLIF (ME-PLIF) utilizes a microendoscope within a tubular retractor for PLIF procedures; however, there are no published reports that compare Microendoscope-assisted to open PLIF. Here we compare the surgical and clinical outcomes of ME-PLIF with those of open PLIF. Materials and Methods: A total of 155 consecutive patients who underwent single-level PLIF were registered prospectively. Of the 149 patients with a complete set of preoperative data, 72 patients underwent ME-PLIF (ME-group), and 77 underwent open PLIF (open-group). Clinical and radiographic findings collected one year after surgery were compared. Results: Of the 149 patients, 57 patients in ME-group and 58 patients in the open-group were available. The ME-PLIF procedure required a significantly shorter operating time and involved less intraoperative blood loss. Three patients in both groups reported dural tears as intraoperative complications. Three patients in ME-group experienced postoperative complications, compared to two patients in the open-group. The fusion rate in ME-group at one year was lower than that in the open group (p = 0.06). The proportion of patients who were satisfied was significantly higher in the ME-group (p = 0.02). Conclusions: ME-PLIF was associated with equivalent post-surgical outcomes and significantly higher rates of patient satisfaction than the traditional open PLIF procedure. However, the fusion rate after ME-PLIF tended to be lower than that after the traditional open method.

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