Usefulness of an expandable interbody spacer for the treatment of XXXX in extremely collapsed disks: preliminary clinical experience with endoscopic posterolateral transforaminal approach.

@entity1 @entity179 @entity158 @entity717 @entity850
STUDY DESIGN: Clinical series of @entity1 with @entity179 undergoing an endoscopic posterolateral transforaminal procedure that used a reaming foraminoplasty technique to enlarge the foramen coupled with insertion of the B-Twin expandable spacer. OBJECTIVES: This retrospective analysis of 107 consecutive @entity1 sought to assess the outcome of this surgical procedure. SUMMARY OF BACKGROUND DATA: Reamed endoscopic foraminoplasty under direct endoscopic vision has been shown to be suitable for extremely collapsed disks (>50% total disk height) despite the difficult access, especially at L5-S1. The authors tried to investigate the efficacy of an expandable spacer being inserted by the endoscopic transforaminal approach to solve @entity850 without bone fusion techniques. METHODS: The procedure consists of bone reaming under direct endoscopic control to wide the foramen followed by insertion of the B-Twin expandable device as a disk spacer to restore partially or to maintain the height of the collapsed disk. Outcome measures included visual analog scale (VAS) for @entity158 , the @entity717 Index (ODI) for functional disability, and radioimaging studies. RESULTS: Mean follow-up was 27.2 months. Clinical outcome was considered excellent in 64 @entity1 , good in 25, fair in 10, and poor in 8. Results were similar in single and double B-Twin spacer insertions. Postoperative mean values for VAS and ODI scores improved significantly as compared with preoperative data. Mean VAS and ODI scores were significantly higher in @entity1 with fair or poor results than in those with excellent or good outcome. In 2 cases, clear signs of end plate bone resorption in the control computed tomographic scans at 6 months and 12 months leading to a substantial loss of disk height were documented. CONCLUSIONS: This preliminary study has shown the efficacy of an endoscopic surgical technique for the treatment of @entity850 in extremely collapsed disks.
