A Review of Fully Endoscopic Lumbar Interbody Fusion

Abstract

Over the past 10 years, fully endoscopic lumbar interbody fusion (FE-LIF) has been widely reported as a rational alternative to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), and several FE approaches for interbody fusion have been published. The short-term surgical outcomes of FE-LIF are reportedly superior to those of MIS-TLIF and conventional posterior LIF in terms of intraoperative blood loss and short-term back pain. However, the complication rate, medium-term clinical outcomes, and fusion rate have not been reported to be different in all uncontrolled studies. The challenges associated with FE-LIF include a longer operative time, which means a steep learning curve, and limited surgical indications, which leads to patient selection bias. FE-LIF is an excellent surgical option for treating degenerative disc disease, spinal instability, and spondylolisthesis. Although the amount of evidence is very small in existing studies and the long-term follow-up data are limited, this technique shows favorable clinical outcomes in selected patients.