The Technical Feasibility of Unilateral Biportal Endoscopic Decompression for The Unpredicted Complication Following Minimally Invasive Transforaminal Lumbar Interbody Fusion: Case Report

다국어 초록 (Multilingual Abstract)

Minimally invasive techniques for transforaminal lumbar interbody fusion (MIS-TLIF) are advantageous because they allow for sufficient surgical exposure and fewer complications through a smaller incision than conventional TLIF. It could be difficult to maintain minimally invasive spine surgery following the unexpected complications after MIS-TLIF. Because MIS-TLIF is usually done via a paramedian small incision with posterior fusion using screws and rods, visualization of the surgical field is limited, and it is difficult to directly assess the neural structure without removing instrumentation. Unilateral biportal endoscopic decompression (UBE) is a rapidly growing surgical method using two 1-cm incisions that are 2 to 3 cm apart. We would like to suggest UBE as an option for immediate reoperation after MIS-TLIF because it has the advantages of targeting pathologic regions and a wide field of visualization through small wounds. The operation is independent of the existing incision from MIS-TLIF, enabling immediate revision surgery without the removal of the screws and rods. UBE has the advantages of targeting specific surgical regions and providing a wide visualization of the operation field through small incisions. UBE can be very useful for discectomy or decompression surgery as well as in immediate reoperation after MISTLIF.

참고문헌 (Reference)

1 Hackenberg L, "Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results" 14 : 551-558, 2005

2 Wagner R, "Transforaminal endoscopic decompression of a postoperative dislocated bone fragment after a 2-level lumbar total disc replacement: case report" 40 : E8-, 2016

3 Schoenfeld AJ, "Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program" 93 : 1577-1582, 2011

4 Rao SJB, "Radiculopathy due to bone chip extrusion following transforaminal lumbar interbody fusion" 5 : 78-81, 2015

5 Kambin P, "Posterolateral percutaneous suctionexcision of herniated lumbar intervertebral discs. Report of interim results" (207) : 37-43, 1986

6 Choi KC, "Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: transforaminal versus interlaminar approach" 16 : 547-556, 2013

7 Lee SH, "Operative failure of percutaneous endoscopic lumbar discectomy: a radiologic analysis of 55 cases" 31 : E285-E290, 2006

8 Holly LT, "Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications" 20 : E6-, 2006

9 Lee WC, "Minimally invasive transforaminal lumbar interbody fusion in multilevel: comparison with conventional transforaminal interbody fusion" 85 : 236-243, 2016

10 Foley KT, "Minimally invasive lumbar fusion" 28 (28): S26-S35, 2003

11 이창규, "Minimally Invasive Transforaminal Lumbar Interbody Fusion Using a Single Interbody Cage and a Tubular Retraction System : Technical Tips, and Perioperative, Radiologic and Clinical Outcomes" 대한신경외과학회 48 (48): 219-224, 2010

12 Mobbs RJ, "Lumbar interbody fusion:techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF" 1 : 2-18, 2015

13 Resnick DK, "Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: lumbar fusion for disc herniation and radiculopathy" 2 : 673-678, 2005

14 Heo DH, "Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results" 43 : E8-, 2017

15 최건, "Endoscopic Spine Surgery" 대한신경외과학회 60 (60): 485-497, 2017

16 Lin GX, "A systematic review of unilateral biportal endoscopic spinal surgery: preliminary clinical results and complications" 125 : 425-432, 2019