Treatment of Degenerative Scoliosis with Percutaneous Spinal Endoscopy Assisted Interbody Fusion and Percutaneous Pedicle Screw Fixation

Abstract

Deformity correction is an integral part of spinal surgery. For patients with painful coronal and sagittal plane deformity, correction to restore lumbar lordosis and scoliosis is the surgical treatment goal. Traditional open spinal surgery techniques are associated with wound problems, long-recovery times, high blood loss, and many other disadvantages compared to their more modern minimally invasive counterparts. While the minimally invasive percutaneous placement of pedicle-screw-rod constructs has been tried, anterior column release and fusion techniques to facilitate deformity correction often require excessive surgical exposures to gain access to the anterior column. This chapter presents a percutaneous transforaminal endoscopic interbody decompression and fusion technique to release the anterior column and facilitate deformity correction with the posterior column pedicle screw constructs. When combined with percutaneous minimally invasive screw placement, the patient's overall burden by the long-segment spinal fusion procedure can be significantly lowered by simplifying the entire procedure and carrying it out through small percutaneous incisions. An illustrative case is presented to demonstrate the utility of endoscopically assisted interbody fusion in scoliosis patients.