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HSS Journal ®
Published in: HSS Journal ® 2/2020

01-07-2020 | Endoscopy | Current Concepts in Spinal Fusion/Surgical Technique

Awake Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note

Authors: Alexander J. Butler, MD, G. Damian Brusko, BS, Michael Y. Wang, MD

Published in: HSS Journal ® | Issue 2/2020

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Abstract

Background

Advances in modern spinal fusion techniques have allowed for less peri-operative morbidity and more rapid recovery from surgery. The addition of endoscopy to minimally invasive surgery (MIS) fusion techniques represents the latest progression of efforts to minimize the impact of surgical intervention.

Technique

MIS transforaminal lumbar interbody fusion (TLIF) is performed endoscopically through a sub-centimeter working portal. Patients undergo light conscious sedation and remain awake to facilitate feedback with the surgeon and enhance post-operative recovery.

Results

Previously reported results of the first 100 cases performed by the senior author at a single institution are summarized. This cohort has been characterized by brief post-operative length of stay, low complication profile, and marked improvement in patient-reported outcomes scores, with no cases of pseudarthrosis at 1-year follow up.

Conclusions

The latest technical considerations and adaptations of a novel technique for endoscopic MIS spinal fusion without general anesthesia are described. A refined surgical technique and anesthetic protocol are presented in detail with recommendations for the successful implementation and performance of the procedure.
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Metadata
Title
Awake Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note
Authors
Alexander J. Butler, MD
G. Damian Brusko, BS
Michael Y. Wang, MD
Publication date
01-07-2020
Publisher
Springer US
Published in
HSS Journal ® / Issue 2/2020
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI
https://doi.org/10.1007/s11420-020-09748-6

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