Purpose:

In this study, a big diameter visible trephine was designed and used in percutaneous endoscopic lumbar interbody fusion to increase endoscopic bone decompression efficiency. Big diameter visible trephine related technical notes and preliminary clinical experience were described.

Methods:

A big diameter visible trephine was designed with normal diameter visible trephine as template. 38 patients with lumbar degenerative diseases who underwent single-level percutaneous endoscopic lumbar interbody fusion with big or normal diameter visible trephine were included into a retrospective study. Operation time, bone decompression time, blood loss, intraoperative fluoroscopy, bone decompression fluoroscopy and dura or nerve injury cases were recorded and analyzed statistically. Visual Analog Scale scores and Oswestry Disability Index were used to analyze the clinical outcomes of the two groups.

Results:

The baseline data of the two groups were statistically similar. There was no significant difference in postoperative VAS and ODI scores between the two groups. Operation time and bone decompression time of big diameter visible trephine group were significantly shorter than that of normal diameter visible trephine group (P < 0.05). Intraoperative fluoroscopy times and bone decompression fluoroscopy times of big diameter visible trephine group were significantly more than that of normal diameter visible trephine group (P < 0.05). Blood loss of the two groups were not statistically different. There were no dura or nerve injury cases in the two groups.

Conclusion:

For percutaneous endoscopic lumbar interbody fusion, the big diameter visible trephine is a safe and efficient endoscopic bone decompression tool under fluoroscopic guidance.