• Mengran Jin, Jun Zhang, Haiyu Shao, Jianwen Liu, and Yazeng Huang.
• Department of Orthopaedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China; People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang Province, China; Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, China.
• Pain Physician. 2020 Mar 1; 23 (2): 165-174.

BackgroundConventional open surgical procedures may cause massive dissections of the spine, higher perioperative complications, prolonged hospitalization, protracted rehabilitation programs and recovery. Percutaneous endoscopic lumbar interbody fusion (PELIF) is an evolving treatment option.ObjectivesTo present the detailed procedure and preliminary clinical and radiologic results of PELIF for degenerative lumbar diseases.Study DesignA retrospective cohort study.SettingA university affiliated tertiary hospital.MethodsThe medical records of patients with degenerative lumbar diseases who underwent PELIF between January 2016 and December 2017 were retrospectively reviewed. Surgical level, surgical time, blood loss, hospital length of stay, and perioperative complications were discussed. Patients were also evaluated for pain by the Visual Analog Scale (VAS), and functional assessment by the Oswestry Disability Index (ODI) and the 36-Item Short Form Health Survey (SF-36), including Physical Component Summary (PCS) and Mental Component Summary (MCS) preoperatively, postoperatively, and during the follow-up period.ResultsThirty-nine consecutive patients (25 men and 14 women) with a mean age of 59.0 years (range, 39-77 years) were enrolled. The average surgical time was 213.8 ± 31.7 minutes (range, 185-324 minutes). Mean estimated blood loss was 25.0 ± 12.6 mL (range, 15-50 mL). At the latest follow-up visit, the VAS scores for back pain, leg pain, ODI, and SF-36 (MCS/PCS) scores improved 89.5%, 95.0%, 71.2%, and 37.5%/58%, respectively. Reoperations were performed in one patient for residual disc mass and one for misplacement of pedicle screw. Fusion was achieved in all patients.LimitationsThe presented results are preliminary and should be interpreted taking the limitations into account, including nonrandomized design, relatively small sample size, and less intensive follow-up period.ConclusionsThe presented PELIF technique seems to be a promising surgical alternative for the treatment of patients with specific degenerative lumbar diseases. Randomized studies with larger sample size and long-term follow-up duration are needed to validate the superiorities of this versatile surgery.Key WordsEndoscopic, minimally invasive spine surgery, lumbar interbody fusion, disc herniation, spondylolisthesis.

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