Endoscopic Transforaminal Lumbar Interbody Fusion Combined With Huge-large Cage Insertion for Lumbar Instability
10.3969/j.issn.1009-6604.2025.05.005
- VernacularTitle:脊柱内镜下经椎间孔腰椎融合术联合超大融合器治疗腰椎不稳定
- Author:
Zhipeng WU
1
;
Xiaolei SONG
1
Author Information
1. 安阳钢铁集团有限责任公司职工总医院脊柱微创外科,安阳 455000
- Publication Type:Journal Article
- Keywords:
Spinal endoscope;
Transforaminal lumbar interbody fusion;
Huge-large cage;
Lumbar instability
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(5):282-288
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical efficacy of endoscopic transforaminal lumbar interbody fusion(Endo-TLIF)combined with huge-large cage insertion technique in the treatment of lumbar instability.Methods A retrospective analysis was made on 18 cases of lumbar instability from May 2022 to August 2022.Endo-TLIF was performed to complete neural decompression,Kambin's triangle exposure,and endplate preparation.A huge-large cage was inserted in the intervertebral space through the Kambin's triangle with full-visualization endoscopy.Results The operation time was(180.3±24.4)min,and the intraoperative blood loss was(72.2±25.6)ml.Symptoms of numbness and weakness in the front thigh were gradually relieved after symptomatic treatment in 1 case.The hospital stay was(7.9±1.8)d.The 18 cases were followed up for 19-22 months(mean,19.9±1.1 months).As compared to pre-operation,Visual Analogue Scale[(2.3±1.4)points vs.(7.7±1.0)points,P=0.000;(1.1±0.4)points vs.(7.7±1.0)points,P=0.000]and Oswestry Disability Index[(18.61±4.79)％ vs.(52.78±8.08)％,P=0.000;(9.28±4.03)％ vs.(52.78±8.08)％,P=0.000]were significantly improved at 3 months after surgery and at final follow-up.As compared to pre-operation,the intervertebral height[(12.56±1.62)mm vs.(8.28±1.27)mm,P=0.000;(12.11±1.45)mm vs.(8.28±1.27)mm,P=0.000]and intervertebral foramen heigh[(22.89±2.00)mm vs.(17.17±1.69)mm,P=0.000;(22.61±1.86)mm vs.(17.17±1.69)mm,P=0.000]were significantly improved at 3 months after surgery and at the final follow-up.All the patients had a good bone fusion,and the excellent and good rate of the modified Macnab criteria was 94.4％(17/18).Conclusion Endo-TLIF combined with huge-large cage insertion can acquire a significantly good clinical outcomes in patients with lumbar instability,with advantages of safe and simple performance,good recovery of intervertebral height,and minimal damage to paraspinal soft tissue.
