Totally endoscopic trans‑superior articular process lumbar interbody fusion: A case series on the development and preliminary evaluation of an innovative minimally invasive lumbar spine surgical technique

The present study is a retrospective analysis aimed at evaluating the early clinical efficacy and preliminary safety of full-endoscopic transforaminal upper facet joint lumbar interbody fusion (TSAP-LIF) in patients with lumbar degenerative diseases treated at the Department of Orthopaedics at Changzhi Yunfeng Hospital (Changzhi, China). The present study collected clinical follow-up data and radiological images, which were accessed and collected between January 1, 2021 and December 31, 2022. All surgeries were performed by the same group of experienced surgeons to ensure consistency in surgical technique and its impact on patient outcomes. The study included patients' preoperative baseline characteristics, operative time, intraoperative blood loss, postoperative complications and follow-up results (with a follow-up period of 6 months). Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS), and radiological evaluations were conducted using postoperative X-rays and computed tomography scans to determine the intervertebral fusion rate. Among the 9 patients, there were 4 men and 5 women, with an average age of 47.3±13.1 years (range, 23-67 years). The average operation time was 113.3±13.9 min, and the average intraoperative blood loss was 101.6±13.8 ml. The postoperative complication rate was 0%. The average hospital stay was 12.7±3.2 days. The average VAS score improved from 7.7±1.4 preoperatively to 2.6±1.2 at 3 months postoperatively and to 1.2±1.1 at 6 months postoperatively. The average ODI score improved from 56.7±8.2 preoperatively to 22.7±5.6 at 1 month postoperatively and to 10.2±4.2 at 6 months postoperatively. Radiological examinations showed an intervertebral fusion rate of 88% at 6 months postoperatively. Retrospective analysis indicates that TSAP-LIF is a safe and effective method for treating lumbar degenerative diseases. The clinical outcomes are significant, with reduced operation time, marked improvement in patient pain and function and a high intervertebral fusion rate. To further evaluate the clinical efficacy of this procedure, larger sample sizes and longer follow-up periods are required.