One-Year Clinical Outcomes and Complication Profile for Endoscopic Transforaminal Lumbar Interbody Fusion

Study Design: Retrospective case series. Objectives: To describe 1‑year clinical and radiographic outcomes after endoscopic transforaminal lumbar interbody fusion (E‑TLIF), for which outcome and fusion data remain limited. Summary of Background Data: Endoscopic surgery has risen in popularity over the past decade for lumbar and cervical decompression. There have been advances in the techniques used to apply this technology during lumbar fusion. However, outcome data and fusion status for these patients are limited. Methods: This retrospective case series evaluated patients undergoing E‑TLIF with 1-year follow-up. Demographics, preoperative and postoperative patient-reported outcome measures, and fusion status were collected. Fusion status was assessed with computed tomography at 1 year, and complications, including reoperation and neurological injury, were recorded. Normality was tested with the Kolmogorov-Smirnov test, and paired comparisons were performed using the Student t test. Results: Twenty‑six patients were included (21 females; mean age, 66.35±17.36 y; mean BMI, 28.56±4.84 kg/m 2 ). At 1 year, visual analog scale back improved from 6.61±2.40 to 3.21±2.60 ( P <0.001), visual analog scale leg from 7.17±2.20 to 2.79±1.83 ( P <0.001), short form-12 physical health from 26.06±4.93 to 31.87±10.17 ( P =0.03), and Oswestry Disability Index from 50.28±12.54 to 34.47±17.07 ( P =0.002). Ten patients obtained 1‑year CT; 9/10 demonstrated interbody fusion and 8/10 posterolateral fusion. One transient unilateral quadriceps palsy occurred after a 2‑level E‑TLIF that resolved on follow-up; 2 cases were converted intraoperatively to tubular TLIF. No additional neurological complications or revision surgeries occurred. Conclusion: E-TLIF demonstrated improvements in pain, function, and disability at 1 year, with a 90% fusion rate among the patients who obtained a 1-year CT. Further research is required to compare outcomes with tubular and open TLIF approaches. Level of Evidence: Level III.