Awake Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note.

HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery
Alexander J ButlerMichael Y Wang

Abstract

Advances in modern spinal fusion techniques have allowed for less peri-operative morbidity and more rapid recovery from surgery. The addition of endoscopy to minimally invasive surgery (MIS) fusion techniques represents the latest progression of efforts to minimize the impact of surgical intervention. MIS transforaminal lumbar interbody fusion (TLIF) is performed endoscopically through a sub-centimeter working portal. Patients undergo light conscious sedation and remain awake to facilitate feedback with the surgeon and enhance post-operative recovery. Previously reported results of the first 100 cases performed by the senior author at a single institution are summarized. This cohort has been characterized by brief post-operative length of stay, low complication profile, and marked improvement in patient-reported outcomes scores, with no cases of pseudarthrosis at 1-year follow up. The latest technical considerations and adaptations of a novel technique for endoscopic MIS spinal fusion without general anesthesia are described. A refined surgical technique and anesthetic protocol are presented in detail with recommendations for the successful implementation and performance of the procedure.

References

Dec 24, 2005·Journal of Neurosurgery. Spine·Robert E IsaacsRichard G Fessler
Apr 8, 2010·JAMA : the Journal of the American Medical Association·Richard A DeyoJeffrey G Jarvik
Feb 12, 2011·Spine·Sean S RajaeeRick B Delamarter
Feb 2, 2016·Neurosurgical Focus·Mitchell HardenbrookAlbert E Telfeian
Feb 2, 2016·Neurosurgical Focus·Albert E TelfeianZiya L Gokaslan
Dec 24, 2016·Journal of Neurosurgery. Spine·Michael Y WangJay Grossman
Apr 5, 2019·Neurospine·Alexander J ButlerJeffrey C Wang

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BETA
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