2022 Volume 13 Issue 8 Pages 1018-1023
Introduction: Trans-Kambin's Triangle Lumbar Interbody Fusion (KLIF) is a technique that involves a cage insertion through Kambin's safety triangle to preserve the posterior elements without exposing the dura. We have developed a full-endoscopic lumbar interbody fusion technique by combining KLIF with Biportal Endoscopic Spine Surgery (BESS), which is an endoscopic spine surgery that uses two portals. In this study, we evaluated the results in patients treated with this technique at 1 year postoperatively.
Methods: Eighteen patients (8 males and 10 females, mean age 68 years) who underwent single-lumbar interbody fusion using this technique were included in the study. The preoperative diagnosis was spondylolisthesis in 13 cases, canal stenosis in 3, recurrent herniation in 1, and foraminal stenosis in 1. The improvement rates of back pain and lower extremity pain and numbness, recovery rate of JOA score, and fusion rate at 1 year postoperatively were evaluated.
Results: At 1 year postoperatively, the improvement rates of back pain, lower extremity pain, and lower extremity numbness were 56%, 73%, and 65%, respectively, and the JOA score recovery rate was 78%. At 1 year postoperatively, 61% (11/18) patients showed fusion on CT imaging.
Discussions: The BE-KLIF technique is a minimally invasive interbody fusion technique that allows bilateral insertion of two 12-mm wide cages and four screws with only four 2-cm incisions. The expandable cages are inserted through Kambin's safety triangle to achieve indirect decompression without exposing the dura. In these cases, the postoperative results were stable, suggesting that indirect decompression with posterior invasion can also improve neurological symptoms.
Conclusions: BE-KLIF is a useful, minimally invasive, full-endoscopic lumbar interbody fusion technique.
