Biportal Endoscopic Transforaminal Interbody Fusion: Comparing Primary Versus Revision Cases.

IF 2.6 2区医学 Q1 ORTHOPEDICS Journal of the American Academy of Orthopaedic Surgeons Pub Date : 2024-12-06 DOI:10.5435/JAAOS-D-23-01031

Ju-Eun Kim, Eugene J Park, Daniel K Park

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Abstract

Background: The safety and efficacy of biportal endoscopic lumbar interbody fusion (BELIF) has been supported by many articles. Advantages include earlier rehabilitation and equal or superior fusion rates compared with other lumbar interbody fusion techniques.

Purpose: To compare the clinical and radiological outcomes of primary and revision biportal endoscopic interbody fusion.

Methods: Seventy-two consecutive patients who underwent primary and revision BELIF and had at least 2-year follow-up were investigated. Clinical outcomes, including Oswestry Disability Index, the visual analog system (VAS), MacNab's criteria, surgical time, and length of hospital stay, were recorded. Radiological outcome was assessed by CT and graded according to Bridwell system.

Results: No notable difference was found in preoperative baselines between the groups. Both groups demonstrated similar clinical improvement in VAS, Oswestry Disability Index, and MacNab criteria. Durotomies were more common in the revision setting (4/33 vs. 0/39 in primary), and surgical time was statistically longer (121.4 ± 21.5 minutes primary versus 179 ± 23.7 minutes revision; P < 0.001). However, no difference was observed in fusion rates at all times points graded by CT scan (94.87% vs. 93.93% primary versus revision at the final follow-up, P = 0.51).

Conclusion: Revision BELIF demonstrate similar clinical and radiographic outcomes compared with primary BELIF, yet surgical time and durotomy risks are increased.

Study design: Retrospective study.

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双门静脉内镜下经椎间孔椎间融合术：比较初次与翻修病例。

背景：双主动脉内窥镜腰椎椎间融合术（BELIF）的安全性和有效性已得到许多文章的支持。与其他腰椎椎体间融合技术相比，其优点包括康复时间更早、融合率相同或更高。目的：比较初次和翻修双束内镜腰椎椎体间融合术的临床和放射学结果：方法：对 72 名接受过初次和翻修 BELIF 并至少随访 2 年的连续患者进行了调查。记录了临床结果，包括 Oswestry 失能指数、视觉模拟系统（VAS）、MacNab 标准、手术时间和住院时间。放射学结果通过 CT 进行评估，并根据布里德维尔系统进行分级：结果：两组患者术前基线无明显差异。两组患者在 VAS、Oswestry 失能指数和 MacNab 标准方面的临床改善情况相似。翻修组的杜罗状切口更常见（4/33，初治组为 0/39），手术时间也更长（初治组为 121.4 ± 21.5 分钟，翻修组为 179 ± 23.7 分钟；P < 0.001）。然而，通过CT扫描分级，各时间点的融合率均无差异（最终随访时，初次手术与翻修手术的融合率分别为94.87%和93.93%，P = 0.51）：研究设计：研究设计：回顾性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Academy of Orthopaedic Surgeons 医学-整形外科

CiteScore

6.10

自引率

6.20%

发文量

529

审稿时长

4-8 weeks

期刊介绍： The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.