2024, Vol. 28 ›› Issue (24): 3873-3878

Uniaxial endoscopic intervertebral fusion combined with pedicle screw fixation in treatment of lumbar degenerative diseases

Tang Long1, Zheng Jiazhuang1, Wang Fandong1, Liu Yuanbin1, Song Zhaojun1, Zhang Zhi2, Wang Miao1, Zhou Yong1, Liu Huiyi1, Chen Yu1   

Abstract: BACKGROUND: With the rapid development of minimally invasive spinal surgery and enhanced recovery after surgery, endoscopic intervertebral fusion techniques have gradually emerged and been widely used in clinical practice in recent years.
OBJECTIVE: To analyze the early clinical efficacy of uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases.
METHODS: 135 patients with lumbar degenerative diseases treated by uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the Suining Central Hospital from October 2020 to December 2021 were enrolled in this study. There were 59 males and 76 females, aged 47-79 years. The lower limb and lumbar pain was evaluated by visual analog scale and lumbar function was assessed by Oswestry disability index before the operation, 1 week, 1, and 6 months after the operation, and at the end of follow-up. The overall pain recovery of patients was evaluated by the scoring criteria for low back pain surgery of Spine Group of Chinese Orthopedic Association and the lumbar physiological curvature and intervertebral fusion were evaluated on lumbar lateral X-ray preoperatively and at the end of follow-up.
RESULTS AND CONCLUSION: (1) The 135 patients were followed up for (17.8±3.0) months after surgery. There was 1 case of endplate injury, 1 case of cerebrospinal fluid leakage, 1 case of nerve root injury, 1 case of intervertebral cage subsidence and displacement, 1 case of chronic infection, and 1 case of pedicle screw rupture. The complication rate was 5.2%. (2) The lumbar visual analog scale score and Oswestry disability index significantly decreased in the waist and lower limbs at various time points postoperatively compared with those preoperatively in 135 patients (P < 0.05). The scoring criteria for low back pain surgery of the Spine Group of the Chinese Orthopedic Association were significantly better at the last follow-up than that preoperatively in 135 patients (P < 0.05). (3) At the last follow-up, there was no significant difference in physiological curvature of lumbar vertebra as compared with that preoperatively in 135 patients (P > 0.05), with a fusion rate of 95.8%. (4) It is concluded that uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases has shown satisfactory early clinical results and is a highly safe minimally invasive spinal surgery mode.

Key words: uniaxial spinal endoscopy, interbody fusion, percutaneous pedicle screw, lumbar degenerative disease, lumbar interbody fusion