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Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note

Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging...

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Autores principales: Kim, Hyeun-Sung, Wu, Pang-Hung, An, Jin-Woo, Lee, Yeon-Jin, Lee, Jun-Hyung, Kim, Myeong-Hun, Lee, Inkyung, Park, Jong-Sung, Park, Jun-Hwan, Jang, Il-Tae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470686/
https://www.ncbi.nlm.nih.gov/pubmed/34573190
http://dx.doi.org/10.3390/brainsci11091169
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author Kim, Hyeun-Sung
Wu, Pang-Hung
An, Jin-Woo
Lee, Yeon-Jin
Lee, Jun-Hyung
Kim, Myeong-Hun
Lee, Inkyung
Park, Jong-Sung
Lee, Jun-Hyung
Park, Jun-Hwan
Jang, Il-Tae
author_facet Kim, Hyeun-Sung
Wu, Pang-Hung
An, Jin-Woo
Lee, Yeon-Jin
Lee, Jun-Hyung
Kim, Myeong-Hun
Lee, Inkyung
Park, Jong-Sung
Lee, Jun-Hyung
Park, Jun-Hwan
Jang, Il-Tae
author_sort Kim, Hyeun-Sung
collection PubMed
description Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging angle, and operation time (inferior articular process resection time/total operation time) and clinical evaluation were made. Result: 48 cases of inside-out and 38 cases of outside-in cases were included. Compared to inside-out, the outside-in approach had significantly less operative time required to resect inferior articular process: 36.55 ± 10.37, and total operative time: 87.45 ± 20.14 min compared to 49.83 ± 23.97 and 102.56 ± 36.53 min, respectively, for the inside-out approach, p < 0.05. Compared to the preoperative state, both cohorts achieved significant improvement of VAS and ODI at post-operative 1 week, 3 months and at final follow up. Both cohorts achieved statistically significant increased disc height with 5.00 ± 2.87 mm, 5.49 ± 2.33 mm and statistically significant improvement in coronal wedge angle with 1.76 ± 1.63°, 3.24 ± 2.92° in the inside-out and outside-in approaches respectively. Conclusions: Complete removal of inferior articular process is the key part of endoscopic fusion with two methods that can be applied: an inside-out approach or an outside-in approach. Comparing both techniques, the outside-in approach has a shorter operative time required for inferior articular process resection and total length of operation with similar good clinical and radiological outcomes.
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spelling pubmed-84706862021-09-27 Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note Kim, Hyeun-Sung Wu, Pang-Hung An, Jin-Woo Lee, Yeon-Jin Lee, Jun-Hyung Kim, Myeong-Hun Lee, Inkyung Park, Jong-Sung Lee, Jun-Hyung Park, Jun-Hwan Jang, Il-Tae Brain Sci Article Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging angle, and operation time (inferior articular process resection time/total operation time) and clinical evaluation were made. Result: 48 cases of inside-out and 38 cases of outside-in cases were included. Compared to inside-out, the outside-in approach had significantly less operative time required to resect inferior articular process: 36.55 ± 10.37, and total operative time: 87.45 ± 20.14 min compared to 49.83 ± 23.97 and 102.56 ± 36.53 min, respectively, for the inside-out approach, p < 0.05. Compared to the preoperative state, both cohorts achieved significant improvement of VAS and ODI at post-operative 1 week, 3 months and at final follow up. Both cohorts achieved statistically significant increased disc height with 5.00 ± 2.87 mm, 5.49 ± 2.33 mm and statistically significant improvement in coronal wedge angle with 1.76 ± 1.63°, 3.24 ± 2.92° in the inside-out and outside-in approaches respectively. Conclusions: Complete removal of inferior articular process is the key part of endoscopic fusion with two methods that can be applied: an inside-out approach or an outside-in approach. Comparing both techniques, the outside-in approach has a shorter operative time required for inferior articular process resection and total length of operation with similar good clinical and radiological outcomes. MDPI 2021-09-03 /pmc/articles/PMC8470686/ /pubmed/34573190 http://dx.doi.org/10.3390/brainsci11091169 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Hyeun-Sung
Wu, Pang-Hung
An, Jin-Woo
Lee, Yeon-Jin
Lee, Jun-Hyung
Kim, Myeong-Hun
Lee, Inkyung
Park, Jong-Sung
Lee, Jun-Hyung
Park, Jun-Hwan
Jang, Il-Tae
Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title_full Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title_fullStr Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title_full_unstemmed Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title_short Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note
title_sort evaluation of two methods (inside-out/outside-in) inferior articular process resection for uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion: technical note
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470686/
https://www.ncbi.nlm.nih.gov/pubmed/34573190
http://dx.doi.org/10.3390/brainsci11091169
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