Clinical and radiological outcomes of spinal endoscopic discectomy–assisted oblique lumbar interbody fusion: preliminary results

摘要

OBJECTIVE Direct neural decompression cannot be achieved by performing lateral lumbar interbody fusion (LLIF). To overcome the indirect decompressive effect of LLIF, additional endoscopic discectomy with oblique lumbar interbody fusion (OLIF) has been attempted. The purpose of this study was to assess the clinical and radiological outcomes of patients who underwent OLIF with additional endoscopic discectomy. METHODS Spinal endoscopic discectomy–assisted OLIF was attempted to remove herniated disc material. Only patients with a follow-up time that exceeded 12 months were enrolled. Clinical parameters examined were the Oswestry Disability Index and visual analog scale scores of back and leg pain. Postoperative MRI was also performed. RESULTS Fourteen patients were enrolled. Central and foraminal disc herniations were evident in 8 and 6 patients, respectively. Concomitant central or foraminal herniated discs were removed completely after additional endoscopic discectomy, and disc removal was confirmed by postoperative MRI. Mean preoperative visual analog scale scores and Oswestry Disability Index scores improved postoperatively. CONCLUSIONS OLIF with additional endoscopic discectomy results in successful direct neural decompression without posterior decompressive procedures. Endoscopic assistance might overcome the limitations of LLIF.