Endoscopic Lateral Lumbar Interbody Fusion

This paper discusses endoscopic lateral lumbar interbody fusion (ELLIF), focusing on its procedure and management of complications. When performing ELLIF, it is necessary to have a thorough understanding of the anatomy of the patient and the techniques and to use the dedicated devices. As a special note, we experienced two cases of complications affecting the intestinal tract out of the 134 cases involving 191 segments of patients with ELLIF. In one case, ileus occurred as the retroperitoneum, and the intestinal tract was impinged between the vertebral body and the cage. In the other, CT-guided iliopsoas drainage and antimicrobial therapy were required due to detection of E. coli, although no intestinal injury was found on contrast-enhanced CT and no obvious contrast leakage was noted by contrast enema. Underweight patients and those diagnosed with posteriorly positioned descending colon on preoperative CT are at risk for intestinal injury as mentioned above and therefore should be eliminated as candidates for ELLIF. As long as indications are followed and performed by surgeons with thorough training of surgical skills, ELLIF is an innovative procedure that is safe, minimally invasive, and provides excellent outcomes.