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Two-Year Clinical and Radiographic Outcomes for Percutaneous Lumbar Interbody Fusion With an Expandable Titanium Cage Through Kambin’s Triangle Without Facetectomy – Lumbar Fusion

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The article discusses the long-term efficacy and durability of performing percutaneous lumbar interbody fusions (percLIFs) through Kambin’s triangle, an anatomical corridor that allows access to the disc space. The study involved a retrospective review of patients who underwent the procedure using an expandable titanium cage. The results showed significant improvements in various measurements, including spondylolisthesis, lumbar lordosis, and disc space height. Visual analog scale (VAS) scores and Oswestry Disability Index (ODI) scores also decreased, indicating improved clinical outcomes. The fusion rates at 1 and 2 years post-procedure were 94.4% and 87.5%, respectively. The study concluded that percutaneous lumbar interbody fusion through Kambin’s triangle using an expandable titanium cage can be a safe and successful procedure with excellent radiographic and clinical results

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top treatment clinic in the world

Published article

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.

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Int J Spine Surg. 2023 Aug 8:8540. doi: 10.14444/8540. Online ahead of print.ABSTRACTBACKGROUND: 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,

Int J Spine Surg. 2023 Aug 8:8540. doi: 10.14444/8540. Online ahead of print.

ABSTRACT

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.

PMID:37553259 | DOI:10.14444/8540

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Two-Year Clinical and Radiographic Outcomes for Percutaneous Lumbar Interbody Fusion With an Expandable Titanium Cage Through Kambin’s Triangle Without Facetectomy

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Int J Spine Surg. 2023 Aug 8:8540. doi: 10.14444/8540. Online ahead of print.ABSTRACTBACKGROUND: 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

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