Clinical Outcomes and Radiologic Parameters of Endoscopic Lumbar Interbody Fusion Using a Novel Nerve Baffle with a Minimum 1-year Follow-up

作者：Ge, Zhilin; He, Jiahui; Zhang, Peng; Zhao, Wenhua; Zhu, Guangye; Zhang, Jiarui; Song, Zefeng; Cui, Jianchao; Jiang, Xiaobing^*; Yu, Weibo

来源：World Neurosurgery, 2023, 176: E181-E189.

DOI：10.1016/j.wneu.2023.05.025

• Baffle
• Endoscopy
• Lumbar interbody fusion
• Radiologic

-OBJECTIVE: Since endoscopic lumbar interbody fusion procedure has established, the insertion of cage requires a large working tube, which may lead to nerve root irritation. A novel nerve baffle was used for endoscopic lumbar interbody fusion (ELIF) and its short-term outcomes were analyzed. -METHODS: A total of 62 patients (32 cases in tube group, 30 cases in baffle group) with lumbar degenerative dis-eases who underwent endoscopic lumbar fusion surgery from July 2017 to September 2021 were retrospectively analyzed. Clinical outcomes were measured using pain visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association Scores (JOA), and complications. Perioperative blood loss was calculated using the Gross formula. Radiologic parameters included lumbar lordosis, surgical segmental lordosis, cage posi-tion, and fusion rate. -RESULTS: There were significant differences in VAS, ODI, and JOA scores postoperatively, 6 months after oper-ation, and at the last follow-up (P < 0.05) within the 2 groups. The VAS and ODI score and hidden blood loss were significantly lower (P < 0.05) for the baffle group. There was no significant difference in lumbar lordosis and segmental lordosis (P > 0.05). Postoperative disc height was significantly higher than preoperative and follow-up disc heights (P < 0.05) for both groups. There was no sta-tistical difference in fusion rate and cage position param-eters or subsidence rate. -CONCLUSIONS: Endoscopic lumbar interbody fusion using the novel baffle has more advantages in nerve pro-tection and hidden blood loss reduction than traditional ELIF with working tube. Compared with the working tube procedure, it has similar or even better short-term clinical outcomes.

• 单位
  Guangzhou University of Chinese Medicine; 1; Southern Medical University