Technical Notes of Full Endoscopic Lumbar Interbody Fusion with Anterior Expandable Cylindrical Fusion Cage: Clinical and Radiographic Outcomes at 1-Year Follow-Up

We sought to introduce technical notes of full endoscopic lumbar interbody fusion (FE-LIF) with an anterior expandable cylindrical fusion cage. This study retrospectively reviewed patients who underwent FE-LIF with an anterior expandable cylindrical fusion cage through transforaminal or interlaminar approaches from August 2018 to April 2019. Patient demographics and operation-related complications were recorded. Clinical and radiologic outcomes were evaluated at 1 year after surgery. A total of 32 patients (34 segments) were included in this study. Among them, 14 received full endoscopic transforaminal lumbar interbody fusion and 18 received full endoscopic interlaminar lumbar interbody fusion. There were significant differences in interbody fusion indications between the 2 groups ( P < 0.05). All operations were successfully completed without complications. Postoperative lumbar magnetic resonance imaging showed that nerve decompression was sufficient in all patients, and the visual analog scale scores of low back pain and leg pain, the Oswestry Disability Index scores, and sensory and muscle strength were significantly improved after surgery ( P < 0.01). The MacNab score included 9 excellent ratings, 4 good ratings, and 1 fair rating in the full endoscopic transforaminal lumbar interbody fusion group and included 10 excellent ratings and 8 good ratings in the full endoscopic interlaminar lumbar interbody fusion group; the scores were not significantly different between the 2 groups at 1 year after surgery ( P > 0.05). Complete interbody fusion was achieved in both groups according to computed tomography at 1 year after surgery. FE-LIF is a safe and effective minimally invasive lumbar surgery with an anterior expandable cylindrical fusion cage.