RT Journal Article
SR Electronic
T1 Two-Year Clinical and Radiographic Outcomes for Percutaneous Lumbar Interbody Fusion With an Expandable Titanium Cage Through Kambin’s Triangle Without Facetectomy
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 760
OP 770
DO 10.14444/8540
VO 17
IS 6
A1 Troy Q. Tabarestani
A1 Timothy Y. Wang
A1 David A.W. Sykes
A1 Vikram A. Mehta
A1 Lexie Z. Yang
A1 Shein-Chung Chow
A1 Christopher I. Shaffrey
A1 Walter F. Wiggins
A1 John H. Chi
A1 Muhammad M. Abd-El-Barr
YR 2023
UL http://ijssurgery.com//content/17/6/760.abstract
AB Background There has been heightened interest in performing percutaneous lumbar interbody fusions (percLIFs) through Kambin’s triangle, an anatomic corridor allowing entrance into the disc space. However, due to its novelty, there are limited data regarding the long-term benefits of this procedure. Our objective was to determine the long-term efficacy and durability of the percutaneous insertion of an expandable titanium cage through Kambin’s triangle without facetectomy.Methods A retrospective review of patients undergoing percLIF via Kambin’s triangle using an expandable titanium cage was performed. Demographics, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), radiographic measurements, perioperative variables, and complications were recorded. VAS, ODI, and radiographic measurements were compared with baseline using the generalized estimating equations assuming normally distributed data. Fusion was assessed with computed tomography (CT) at 1 and 2 years after the procedure.Results A total of 49 patients were included. Spondylolisthesis, lumbar lordosis (LL), sacral slope, pelvic tilt, and anterior/posterior disc space height were all significantly improved postoperatively at each time point of 3, 6, 12, and 24 months (P < 0.001). Pelvic incidence—LL mismatch decreased significantly at each follow-up (P < 0.001) with a mean reduction of 4° by 24 months. VAS back scores reduced by >2 points at the 6, 12, and 24 month follow-ups. ODI scores reduced by >15 points at the 12- and 24-month follow-ups. Of the patients who had 1- and 2-year CT images, fusion rates at those time points were 94.4% (17/18) and 87.5% (7/8), respectively. The mean annual rate of surgically significant adjacent segment disease was 2.74% through an average follow-up of 2.74 years.Conclusion These results highlight that percLIF, a procedure done without an endoscope or facetectomy, can be performed using an expandable titanium cage through Kambin’s triangle with excellent radiographic and clinical results.Clinical Relevance percLIF via Kambin’s triangle is a safe and succesful procedure with long-term improvements in both clinical and radiographic outcomes.Level of Evidence 3.