A less invasive treatment by a full-endoscopic spine surgery for adjacent segment disease after lumbar interbody fusion.

BACKGROUND

Full-endoscopic spine surgery (FESS) is a suitable treatment for lumbar disc herniation (LDH) and foraminal stenosis. This study investigated the usefulness of FESS in treating adjacent segment disease (ASD) after lumbar interbody fusion (LIF).

METHODS

Between September 2015 and March 2019, a total of 13 patients with symptomatic ASD after LIF underwent FESS. Discectomy and foraminoplasty using a 3.5-mm diameter high-speed drill were performed for treating LDH and foraminal stenosis. Preoperative and postoperative statuses were evaluated using Numerical Rating Scale (NRS) and the modified Japanese Orthopedic Association (mJOA) scores.

RESULTS

The patients' mean age was 64.8 years; there were 10 male and 3 female patients. The mean operative time was 52.7 min. The mean pre- and postoperative NRS scores were 7.6 and 3.1, respectively. The mean pre- and postoperative mJOA scores were 10.5 and 16.1, respectively, and the mean recovery rate was 32.8%. Subsequent operative treatments were required in 3 patients for postoperative complication, insufficient decompression, and recurrence LDH.

CONCLUSIONS

FESS is a safe and effective minimally invasive treatment for ASD after LIF and a potential alternative to extend the LIF to the adjacent vertebra or sacrum.

Informations de copyright

2020 Journal of Spine Surgery. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jss.2019.08.04). The series “Full-endoscopic Spine Surgery” was commissioned by the editorial office without any funding or sponsorship. HK served as the unpaid Guest Editor of the series and serves as an unpaid editorial member of Journal of Spine Surgery from October 2018 to October 2020. The other authors have no other conflicts of interest to declare.