Modified Transfacet Full-Endoscopic Lumbar Interbody Fusion: 1-Year Clinical and Radiological Outcomes

Objective: Full-endoscopic lumbar interbody fusion (FE-LIF) has emerged as a tissue-sparing alternative to traditional fusion; however, its technical complexity remains a barrier to widespread adoption. This study evaluated the 1-year clinical and radiological outcomes of a modified transfacet FE-LIF technique designed to optimize the working corridor for single-level degenerative lumbar pathology.Methods: A retrospective cohort analysis was conducted in 41 patients who underwent single-level modified transfacet FE-LIF between January 2023 and June 2024. The surgical technique used a keyhole facetectomy to access the disc space while protecting adjacent neural structures. Clinical outcomes were assessed using the visual analogue scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) preoperatively and at 1, 6, and 12 months postoperatively. Fusion status was evaluated using computed tomography (CT) at 1 year according to the Bridwell criteria.Results: The cohort had a mean age of 61.9 years and demonstrated favorable perioperative metrics, including a mean operative time of 143.9±12.0 minutes, estimated blood loss of 91.3±22.6 mL, and hospital stay of 3.1±0.8 days. Clinical improvement was substantial: VAS scores for back and leg pain decreased by 86.5% and 89.2%, respectively, and ODI improved from 67.61% preoperatively to 10.29% at 12 months (p<0.001). CT assessment confirmed a solid fusion rate of 95.1% according to Bridwell grades I–II, with no major perioperative complications or implant failures.Conclusion: The modified transfacet FE-LIF technique appears to be a safe, effective, and reproducible minimally invasive procedure. It was associated with significant symptom relief and a high fusion rate comparable to established benchmarks, suggesting that this facet-based approach may minimize soft tissue trauma while facilitating the endoscopic learning curve.