Full-Endoscopic Posterior Lumbar Interbody Fusion with Epidural Anesthesia: Technical Note and Initial Clinical Experience with One-Year Follow-Up

Objective: The purpose of this study was to introduce and evaluate the early clinical outcomes of the full-endoscopic posterior lumbar interbody fusion (Endo-PLIF) technique with epidural anesthesia (EA) for single-segment lumbar degenerative diseases. Methods: In this retrospective case series study, we explored the feasibility and effectiveness of the Endo-PLIF with EA for single-segment lumbar degenerative diseases. Between March 2018 and January 2019, a series of 24 patients with single-segment lumbar degenerative diseases underwent Endo-PLIF surgery and were followed up for a minimum of 12 months (15.21 +/- 2.27 months). Clinical outcomes including visual analog scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, and the Short Form-36 health survey questionnaire (SF-36) were evaluated preoperatively, and postoperatively at 3 days and at 3, 6, and 12-months. Results: All patients underwent successful single-segment Endo-PLIF surgery. The mean operation time was 209.17 +/- 39.49 min, and average amount of bleeding was 43.33 +/- 14.87 mL. The VAS for lower extremity pain and back pain significantly improved at 3 days, and at 3, 6, 12 months compared with preoperative, respectively. The ODI scores decreased from 42.04 +/- 3.96 to 12.75 +/- 2.71 (P<0.001) at preoperative and 12 months postoperatively, respectively. The SF-36 Physical Component Scores (PCS) improved from 34.96 +/- 4.63 preoperatively to 52.08 +/- 6.05 (P<0.001) at 12 months postoperatively. Additionally, the SF-36 Mental Component Scores (MCS) improved from 39.38 +/- 5.70 at preoperative to 53.13 +/- 5.97 (P<0.001) at 12 months postoperatively. Two patients experienced dysesthesia, and one patient had a wound infection. Conclusion: Endo-PLIF with EA is a feasible and valuable technique for the treatment of single-segment lumbar degenerative diseases in selected patients.