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<p>To explore the clinical outcomes of coaxial endoscopic lumbar interbody fusion (CELIF) with three distinct fusion methods in the treatment of lumbar degenerative diseases. We retrospectively analyzed clinical data of patients who underwent CELIF surgery to treat lumbar degenerative diseases from January 2018 to January 2020. Patients were divided into three groups as follows: patients with the deproteinized and demineralized bovine bone fusion cage (heterogeneous compact internal fixators (HCIF) cage) and bilateral pedicle screw (BPS) fixation were included in Group HCIF-four (<i>n</i> = 23); patients with HCIF cage and unilateral pedicle screw, combined with contralateral translaminar facet screw (UPS + TLFS) fixation, were included in Group HCIF-three (<i>n</i> = 28); and patients with height-adjustable metal fusion cage and BPS fixation were included in Group metal-four (<i>n</i> = 26). Clinical symptoms were evaluated using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). In addition, radiological outcomes were assessed via intervertebral height (IH), neuroforamen height (NH), and segmental angle (SA) prior to surgery, 7 days after surgery, and at the last follow-up. All patients demonstrated significant improvement in symptoms and imaging findings after surgery. At the last follow-up, the VAS, ODI, and imaging indices of Group metal-four were significantly better than those of Group HCIF-three (<i>P</i> &lt; 0.05), whereas Group HCIF-four values were intermediate. The interbody fusion rates for Groups metal-four, HCIF-three, and HCIF-four were 88.46%, 71.43%, and 82.61%, respectively (<i>P</i> = 0.009 &lt; 0.05), and the satisfaction rates were 96.15%, 71.43%, and 82.61%, respectively (<i>P</i> = 0.078 &gt; 0.05). CELIF is a safe and effective minimally invasive surgical intervention for the treatment of lumbar degenerative diseases. Among the three analyzed groups, the height-adjustable metal fusion cage combined with BPS fixation may provide superior clinical and fusion outcomes. HCIF cage combined with UPS + TLFS may be associated with lower fusion rates and higher subsidence, although further prospective studies are needed to confirm these findings.</p>

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Evaluation of three methods of coaxial endoscopic lumbar fusion for treating lumbar degenerative diseases: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年1月30日

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  • Wenbo Diao,
  • Xueya Feng,
  • Yuanli Li,
  • Jian Gao,
  • Haoran Chen,
  • Qianchun Li

摘要

To explore the clinical outcomes of coaxial endoscopic lumbar interbody fusion (CELIF) with three distinct fusion methods in the treatment of lumbar degenerative diseases. We retrospectively analyzed clinical data of patients who underwent CELIF surgery to treat lumbar degenerative diseases from January 2018 to January 2020. Patients were divided into three groups as follows: patients with the deproteinized and demineralized bovine bone fusion cage (heterogeneous compact internal fixators (HCIF) cage) and bilateral pedicle screw (BPS) fixation were included in Group HCIF-four (n = 23); patients with HCIF cage and unilateral pedicle screw, combined with contralateral translaminar facet screw (UPS + TLFS) fixation, were included in Group HCIF-three (n = 28); and patients with height-adjustable metal fusion cage and BPS fixation were included in Group metal-four (n = 26). Clinical symptoms were evaluated using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). In addition, radiological outcomes were assessed via intervertebral height (IH), neuroforamen height (NH), and segmental angle (SA) prior to surgery, 7 days after surgery, and at the last follow-up. All patients demonstrated significant improvement in symptoms and imaging findings after surgery. At the last follow-up, the VAS, ODI, and imaging indices of Group metal-four were significantly better than those of Group HCIF-three (P < 0.05), whereas Group HCIF-four values were intermediate. The interbody fusion rates for Groups metal-four, HCIF-three, and HCIF-four were 88.46%, 71.43%, and 82.61%, respectively (P = 0.009 < 0.05), and the satisfaction rates were 96.15%, 71.43%, and 82.61%, respectively (P = 0.078 > 0.05). CELIF is a safe and effective minimally invasive surgical intervention for the treatment of lumbar degenerative diseases. Among the three analyzed groups, the height-adjustable metal fusion cage combined with BPS fixation may provide superior clinical and fusion outcomes. HCIF cage combined with UPS + TLFS may be associated with lower fusion rates and higher subsidence, although further prospective studies are needed to confirm these findings.