Clinical efficacy of dual operation channels full-endoscopic far-lateral transforaminal lumbar interbody fusion for the treatment of lumbar spondylolisthesis

English Keywords:Lumbar spondylolisthesis  Dual-operation channels technique  Full-endoscopic  Far-lateral transforaminal approach  Lumbar interbody fusion

English Abstract:

  【Abstract】 Objectives: To analyze the clinical efficacy of far-lateral transforaminal lumbar interbody fusion(TLIF) under a full-endoscope with dual-operation channels for the treatment of lumbar spondylolisthesis. Methods: A retrospective analysis was conducted on the clinical data of 20 patients with single-level lumbar spondylolisthesis who underwent dual-operation channels full-endoscopic far-lateral TLIF at the Department of Neck-shoulder and Lumbocrural Pain Division 1, Sichuan Orthopedic Hospital, from June 2023 to December 2023. Among the patients, there were 15 cases of degenerative spondylolisthesis and 5 cases of isthmic spondylolisthesis; 7 females and 13 males, aged 49 to 72 years(59.95±7.16 years). The duration of symptoms ranged from 2 to 120 months(35.15±42.10 months). The operative time, intraoperative blood loss, length of hospital stay, and surgical complications were recorded. Clinical outcomes were assessed using the Oswestry disability index(ODI) and visual analog scale(VAS) scores for back and leg pain, preoperatively, 1 month postoperatively, and at the final follow-up. Lumbar CT scans were used to evaluate interbody fusion according to the Bridwell criteria. Results: All the patients successfully underwent endoscopic fusion surgery. The operative time was 175min to 235min(201.75±24.40min). The follow-up period for all the cases was 12-16 months, with an average of 14.15±1.14 months. One month after surgery and final follow-up ODI, as well as VAS scores for both lower back pain and leg pain, showed significant improvement compared to preoperative levels(P<0.05). No serious complications occurred intraoperatively, postoperatively, or during the follow-up period. Of the 20 patients who underwent lumbar CT scans during the follow-up period, 19(95.0%) achieved solid bony fusion. Conclusions: The far-lateral TLIF under a dual-operation channels full-endoscope demonstrate satisfactory clinical outcomes in early follow-up, which offers a minimally invasive, safe, and effective option for the treatment of lumbar spondylolisthesis.