Medicina (Feb 2021)

Microendoscope-Assisted Versus Open Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease: A Multicenter Retrospective Cohort Study

  • Masayoshi Fukushima,
  • Nozomu Ohtomo,
  • Michita Noma,
  • Yudai Kumanomido,
  • Hiroyuki Nakarai,
  • Keiichiro Tozawa,
  • Yuichi Yoshida,
  • Ryuji Sakamoto,
  • Junya Miyahara,
  • Masato Anno,
  • Naohiro Kawamura,
  • Akiro Higashikawa,
  • Yujiro Takeshita,
  • Hirohiko Inanami,
  • Sakae Tanaka,
  • Yasushi Oshima

DOI
https://doi.org/10.3390/medicina57020150
Journal volume & issue
Vol. 57, no. 2
p. 150

Abstract

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Background and objectives: Minimally invasive surgery has become popular for posterior lumbar interbody fusion (PLIF). Microendoscope-assisted PLIF (ME-PLIF) utilizes a microendoscope within a tubular retractor for PLIF procedures; however, there are no published reports that compare Microendoscope-assisted to open PLIF. Here we compare the surgical and clinical outcomes of ME-PLIF with those of open PLIF. Materials and Methods: A total of 155 consecutive patients who underwent single-level PLIF were registered prospectively. Of the 149 patients with a complete set of preoperative data, 72 patients underwent ME-PLIF (ME-group), and 77 underwent open PLIF (open-group). Clinical and radiographic findings collected one year after surgery were compared. Results: Of the 149 patients, 57 patients in ME-group and 58 patients in the open-group were available. The ME-PLIF procedure required a significantly shorter operating time and involved less intraoperative blood loss. Three patients in both groups reported dural tears as intraoperative complications. Three patients in ME-group experienced postoperative complications, compared to two patients in the open-group. The fusion rate in ME-group at one year was lower than that in the open group (p = 0.06). The proportion of patients who were satisfied was significantly higher in the ME-group (p = 0.02). Conclusions: ME-PLIF was associated with equivalent post-surgical outcomes and significantly higher rates of patient satisfaction than the traditional open PLIF procedure. However, the fusion rate after ME-PLIF tended to be lower than that after the traditional open method.

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