Background: Percutaneous endoscopic posterior lumbar interbody fusion was a new technique that leads to improved visualization, improved safety and less trauma than does the traditional procedure.
Purpose: The purpose of this study was to explore the revision strategy of percutaneous endoscopic posterior lumbar interbody fusion (PE-PLIF) for symptomatic lumbar degenerative disc disease, and determine its efficacy and clinical outcomes, and develope a revision strategy.
Methods: From November 2020 to January 2023, The clinical data that 200 patients of symptomatic lumbar degenerative disc disease treated with PE-PLIF were analyzed. 200 patients with an average age of 65.5±5.8 years. Follow-up time was 2 years.The reoperative parameters and postoperative radiographic parameters were measured to evaluate the effectiveness of the operation. The fusion is assessed by plain radiographs in follow up.The visual analog scale (VAS) back pain, VAS leg pain for pain and the Oswestry disability index (ODI),Japanese Orthopaedic Association score for function assessment were used to evaluate clinical efficacy.
Results: The mean estimated volume of blood loss was 60.5±15.6ml, operative time was 120.8±20.0 minutes. PE-PLIF significantly reduced ODI score, and improved the posterior disc height, lumbar lordosis angle and segmental lordosis angle (p < 0.05). The VAS leg pain score was reduced to 2 from preoperative score of 8 and the VAS back pain score reduced 3 from preoperative score of 9. Japanese Orthopaedic Association score was reduced to 4 from preoperative score of 20.The neurogenic symptom score of patients improved from 8 before surgery to 1 at the last follow-up.The rate of patient satisfaction was 98.8%. The fusion rates were 95.0% , the cage subsidence rates were 12.6%.
Conclusion: The results from this study indicate that PE-PLIF is a minimally invasive, safe, reliable, and effective revision strategy for symptomatic lumbar degenerative disc disease. The study concluded that PE-PLIF is also effective for disc generation and improves sagittal balance. With less trauma and faster recovery, PE-PLIF could be an alternative option.Surgical experience, detailed clinical examination, precise positioning and choosing adaptive indication are the key for the success.
