Our experience with the use of unilateral biportal endoscopic lumbar interbody fusion (UBLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of patients with spinal stenosis of the lumbar spine

Authors

DOI:

https://doi.org/10.14739/2310-1237.2020.3.221822

Keywords:

unilateral biportal endoscopic lumbar interbody fusion, posterior lumbar interbody fusion

Abstract

 

In addition to endoscopic discectomy, patients with stenosis of the spinal canal of the lumbar spine quite often undergo endoscopic decompression and / or stabilization. Spinal endoscopic surgery has several advantages compared to open operations, however, the lack of differences in long-term clinical results, a small workspace with a limited field of view and a large learning curve compared to conventional operations are disadvantages of endoscopic spinal surgery.

The aim of the study was to compare the clinical and radiological results of unilateral biportal endoscopic lumbar interbody fusion (UBLIF) versus conventional posterior lumbar interbody fusion (PLIF) using data from a one-year follow-up period.

Material and methods. 25 patients underwent surgery using the UBLIF method (age 68 ± 8 years) and 31 patients underwent surgery using the PLIF method (66 ± 9 years) at one lumbosacral level (observation period – 1 year). Perioperative data, clinical results (the level of pain in the back and legs according to VAS (cm), and the level of disability – using the Oswestry Disability Index (ODI, %)) were evaluated.

Results. In our study, we analyzed the effectiveness of two methods: unilateral biportal endoscopic lumbar interbody fusion (UBLIF) and traditional posterior lumbar interbody fusion (PLIF). Assessment of back pain: a significant improvement 1 week after surgery was observed in the UBLIF group (3.8 ± 1.0 cm), while in the PLIF group the dynamics was insignificant (5.2 ± 1.1 cm); the index of back pain in the PLIF group significantly improved only after 1 year (in PLIF – 3.4 ± 1.4 cm, in UBLIF – 3.1 ± 0.8 cm). Assessing the quality of life, positive dynamics by Oswestry Disability Index (ODI) was observed during 1 year of observation in both groups (UBLIF 32.7 ± 5.6 %, in PLIF 29.2 ± 10.1 %), no significant differences in the frequency of complications between the groups were revealed.

Conclusions. UBLIF is less invasive compared to PLIF, however, UBLIF requires more time for surgery than PLIF. When performing PLIF surgery, the positive aspect is shorter surgery time, negative – a greater number of patients requiring blood transfusion than with UBLIF surgery.

References

Basques, B. A., Golinvaux, N. S., Bohl, D. D., Yacob, A., Toy, J. O., Varthi, A. G., & Grauer, J. N. (2014). Use of an operating microscope during spine surgery is associated with minor increases in operating room times and no increased risk of infection. Spine, 39(22), 1910-1916. https://doi.org/10.1097/BRS.0000000000000558

Boukebir, M. A., Berlin, C. D., Navarro-Ramirez, R., Heiland, T., Schöller, K., Rawanduzy, C., Kirnaz, S., Jada, A., & Härtl, R. (2017). Ten-Step Minimally Invasive Spine Lumbar Decompression and Dural Repair Through Tubular Retractors. Operative neurosurgery, 13(2), 232-245. https://doi.org/10.1227/NEU.0000000000001407

Elkan, P., Sten-Linder, M., Hedlund, R., Willers, U., Ponzer, S., & Gerdhem, P. (2016). Markers of inflammation and fibrinolysis in relation to outcome after surgery for lumbar disc herniation. A prospective study on 177 patients. European spine journal, 25(1), 186-191. https://doi.org/10.1007/s00586-015-3998-7

Gibson, J., Subramanian, A. S., & Scott, C. (2017). A randomised controlled trial of transforaminal endoscopic discectomy vs microdiscectomy. European spine journal, 26(3), 847-856. https://doi.org/10.1007/s00586-016-4885-6

Hara, M., Takahashi, H., Yokoyama, Y., Wada, A., Hasegawa, K., & Iida, Y. (2015). Comparison of the invasiveness of conventional discectomy and microendoscopic discectomy for lumbar disc herniation: Differences in the methods of approach. Asian journal of endoscopic surgery, 8(1), 40-47. https://doi.org/10.1111/ases.12143

Heo, D. H., Son, S. K., Eum, J. H., & Park, C. K. (2017). Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: technical note and preliminary clinical results. Neurosurgical focus, 43(2), E8. https://doi.org/10.3171/2017.5.FOCUS17146

Hsu, H. T., Chang, S. J., Yang, S. S., & Chai, C. L. (2013). Learning curve of full-endoscopic lumbar discectomy. European spine journal, 22(4), 727-733. https://doi.org/10.1007/s00586-012-2540-4

Hwa Eum, J., Hwa Heo, D., Son, S. K., & Park, C. K. (2016). Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: a technical note and preliminary clinical results. Journal of neurosurgery. Spine, 24(4), 602-607. https://doi.org/10.3171/2015.7.SPINE15304

Jacquot, F., & Gastambide, D. (2013). Percutaneous endoscopic transforaminal lumbar interbody fusion: is it worth it?. International orthopaedics, 37(8), 1507-1510. https://doi.org/10.1007/s00264-013-1905-6

Jin-Tao, Q., Yu, T., Mei, W., Xu-Dong, T., Tian-Jian, Z., Guo-Hua, S., Lei, C., Yue, H., Zi-Tian, W., & Yue, Z. (2015). Comparison of MIS vs. open PLIF/TLIF with regard to clinical improvement, fusion rate, and incidence of major complication: a meta-analysis. European spine journal, 24(5), 1058-1065. https://doi.org/10.1007/s00586-015-3890-5

Komp, M., Hahn, P., Oezdemir, S., Giannakopoulos, A., Heikenfeld, R., Kasch, R., Merk, H., Godolias, G., & Ruetten, S. (2015). Bilateral spinal decompression of lumbar central stenosis with the full-endoscopic interlaminar versus microsurgical laminotomy technique: a prospective, randomized, controlled study. Pain physician, 18(1), 61-70.

Lee, C. H., Choi, M., Ryu, D. S., Choi, I., Kim, C. H., Kim, H. S., & Sohn, M. J. (2018). Efficacy and Safety of Full-endoscopic Decompression via Interlaminar Approach for Central or Lateral Recess Spinal Stenosis of the Lumbar Spine: A Meta-analysis. Spine, 43(24), 1756-1764. https://doi.org/10.1097/BRS.0000000000002708

Lee, K. H., Yue, W. M., Yeo, W., Soeharno, H., & Tan, S. B. (2012). Clinical and radiological outcomes of open versus minimally invasive transforaminal lumbar interbody fusion. European spine journal, 21(11), 2265-2270. https://doi.org/10.1007/s00586-012-2281-4

Lee, S., Lee, J. W., Yeom, J. S., Kim, K. J., Kim, H. J., Chung, S. K., & Kang, H. S. (2010). A practical MRI grading system for lumbar foraminal stenosis. AJR. American journal of roentgenology, 194(4), 1095-1098. https://doi.org/10.2214/AJR.09.2772

Rasouli, M. R., Rahimi-Movaghar, V., Shokraneh, F., Moradi-Lakeh, M., & Chou, R. (2014). Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation. The Cochrane database of systematic reviews, (9), CD010328. https://doi.org/10.1002/14651858.CD010328.pub2

Ruan, W., Feng, F., Liu, Z., Xie, J., Cai, L., & Ping, A. (2016). Comparison of percutaneous endoscopic lumbar discectomy versus open lumbar microdiscectomy for lumbar disc herniation: A meta-analysis. International journal of surgery, 31, 86-92. https://doi.org/10.1016/j.ijsu.2016.05.061

Torudom, Y., & Dilokhuttakarn, T. (2016). Two Portal Percutaneous Endoscopic Decompression for Lumbar Spinal Stenosis: Preliminary Study. Asian spine journal, 10(2), 335-342. https://doi.org/10.4184/asj.2016.10.2.335

Wang, M. Y., & Grossman, J. (2016). Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up. Neurosurgical focus, 40(2), E13. https://doi.org/10.3171/2015.11.FOCUS15435

Youn, M. S., Shin, J. K., Goh, T. S., & Lee, J. S. (2018). Full endoscopic lumbar interbody fusion (FELIF): technical note. European spine journal, 27(8), 1949-1955. https://doi.org/10.1007/s00586-018-5521-4

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1.
Fishchenko IV, Roy IV, Vladymirov AA, Kravchuk LD, Blonskyi RI. Our experience with the use of unilateral biportal endoscopic lumbar interbody fusion (UBLIF) and posterior lumbar interbody fusion (PLIF) in the treatment of patients with spinal stenosis of the lumbar spine. Pathologia [Internet]. 2020Dec.29 [cited 2024Nov.22];(3). Available from: http://pat.zsmu.edu.ua/article/view/221822

Issue

No. 3 (2020)

Section

Original research

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