Percutaneous Endoscopic Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Spinal Stenosis: Preliminary Report of Seven Cases with 12-Month Follow-Up

Abstract

Purpose. The objective of this study was to investigate the preliminary effectiveness of percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) for the treatment of lumbar spinal stenosis (LSS). Methods. From September 2016 to June 2017, a series of seven patients consisting of six females and one male with an average age of 55.25 years (range 43–77 years) who were diagnosed with LSS were involved in this study. All patients were treated by PE-TLIF. During perioperative and follow-up period, demographic data, operation time, intraoperative blood loss, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria were evaluated and perioperative complications were documented. Results. All patients were followed up for more than 12 months, with an average follow-up time of 15 (range 12-21) months. The mean VAS of back pain was 7.43 (range 6-8) preoperatively and 0.86 (range 0-2) at the final follow-up. The mean VAS of leg pain was 6.14 (range 4-9) preoperatively and 0.71 (range 0-1) at the final follow-up. The mean ODI was 53.57% (range 38%-63%) preoperatively and 15.57% (range 5%-26%) at the final follow-up. In three-month follow-up, continuous bone trabeculae bridging between intervertebral bodies was seen in 3 cases, and the remaining 4 cases could identify continuous bone trabeculae bridging at 6-month follow-up, reaching the standard of spinal intervertebral fusion. At the final follow-up, 4 patients were rated as excellent (4/7) and 3 patients were rated as good (3/7) according to the modified MacNab criteria. Conclusions. Our study suggested that percutaneous endoscopic transforaminal lumbar interbody fusion could acquire satisfactory treatment effects for the patients with lumbar spinal stenosis, even for the patient who could not afford general anesthesia.