145 - Minimally invasive transforaminal lumbar interbody fusion by a novel two medium compatible bi-channel endoscopy system, technique note and preliminary clinical results

Introduction: Lumbar interbody fusion surgery is a well-established treatment option for lumbar degenerative diseases, such as lumbar spondylolisthesis. Basing on the equipment, endoscopic assisted TLIF can be classified into percutaneous endoscopic TLIF (PE-TLIF), biportal endoscopic TLIF and microendoscopic TLIF. According to the working medium, the current spinal endoscopy systems can be divided into water-medium endoscopy such as percutaneous endoscopy system and air-medium endoscopy such as microendoscopic discectomy (MED) system. And due to the difference of structure, the current spinal endoscopy can be also divided into single-channel endoscopy such as percutaneous endoscopy system and bi-channel endoscopy system such as unilateral biportal endoscopy (UBE) system. We hereby introduce a novel two medium compatible bi-channel endoscopy system named V-Shape Bichannel Endoscopy (VBE) system for spinal surgery and share the primary application experience of VBE assisted TLIF surgery (VBE-TLIF).

Aims: Our team designed a novel two medium compatible bi-channel endoscopy system for spinal surgery, V-Shape Bichannel Endoscopy (VBE) system. Hereby, this study will introduce minimally invasive transforaminal lumbar interbody fusion (TLIF) with VBE system and report its preliminary clinical results.

Methods: 52 participants, who accepted VBE assisted TLIF surgery (VBE-TLIF) in our hospital were included in this study. The duration of operation, off-bed time and days of hospitalization were recorded. Besides, the patient's preoperative and postoperative pain was evaluated via visual analog scale (VAS), the functional status was evaluated via Oswestry dysfunction index (ODI) and modified MacNab criteria. Patients were asked to follow up in the outpatient department at the 3rd, 6th, 12th and 24th month after surgery. X-ray or CT were examined to evaluate the internal fixation position and interbody fusion result.

Results: All patients received unilateral decompression with an average operation duration of 178.49±27.49 minutes. After the surgery, their VAS score of leg pain and back pain reduced significantly. At the last follow-up, the VAS score of leg pain and back pain was 0.80±0.69 and 0.86±0.75 separately. The difference shows statistically significant with p< 0.05. At the last follow-up, the ODI was 15.2±5.75. According to modified MacNab criteria, 39 patients rated their function as excellent, and 10 patients were good. The overall satisfaction rate reached 94%.

Conclusion: The VBE system reported in the current study can complete TLIF surgery safely and effectively.