Minimally invasive lumbar endoscopic discectomy and interbody fusion with percutaneous posterior cortical-trajectory pedicle screw and rod stabilization – A case series

• Main Authors: Vikram B. Chakravarthy, Joshua L. Golubovsky, Michael P. Steinmetz
• Format: Article
• Language: English
• Published: Elsevier 2021-03-01
• Series: Interdisciplinary Neurosurgery
• Subjects: Cortical; Endoscopic; Fusion; Lumbar; Minimally invasive surgery
• Online Access: http://www.sciencedirect.com/science/article/pii/S221475192030596X

Minimally invasive (MIS) lumbar endoscopic discectomy and MIS interbody cage fusion, augmented by a posterior percutaneous pedicle screw and rod instrumented stabilization is increasing in popularity for the surgical management of degenerative lumbar pathology. Minimally invasive techniques are favored as they entail less muscle and tissue dissection, shorter recovery time, less blood loss, and shorter hospital length of stay compared to conventional open techniques. We provide a novel description of performing an endoscopic discectomy with interbody cage placement followed by minimal access posterior approach cortical-trajectory pedicle screw and rod stabilization. Methods: We performed a retrospective chart review of five patients who underwent a MIS single level lumbar endoscopic discectomy and interbody fusion augmented by posterior cortical-trajectory pedicle screw and rod instrumented stabilization. Surgical techniques are discussed in detail and clinical outcomes for each case were reviewed. Results: We present five patients who underwent MIS endoscopic discectomy and interbody cage fusion augmented by percutaneous cortical-trajectory pedicle screw and rod instrumented stabilization. All patients demonstrated improvement in pain postoperatively with only one relevant complication. Conclusions: The cases reviewed illustrate the feasibility of performing MIS endoscopic discectomy and interbody cage fusion augmented by percutaneous cortical-trajectory pedicle screw and rod instrumented stabilization for select patient populations.