Full-Endoscopic Decompression Combined with Oblique Lumbar Interbody Fusion for Treating Lumbar Spinal Stenosis with Prolapsed Nucleus Pulposus.

Oblique lumbar interbody fusion (OLIF) has been widely used to treat lumbar spinal stenosis. However, patients with prolapsed nucleus pulposus are not suitable for this surgery. We introduce a hybrid surgical procedure combining OLIF and full-endoscopic spinal canal decompression to address this issue. During the OLIF procedure, after completing the discectomy, the endoscopic system is inserted into the intervertebral space to perform the latter half of the discectomy, remove the loose nucleus pulposus, and achieve direct decompression of the nerve root under visualization. After decompression, the free nerve root can be seen under the endoscopic view. With the assistance of endoscopy, the indications for OLIF surgery can be expanded, allowing for the treatment of cases with sciatica caused by the nucleus pulposus. Intraoperative X-ray fluoroscopy can determine the direction and location of decompression under the endoscopy. All patients experienced satisfactory relief from their lumbar and leg pain after the surgery with no complications. Full-endoscopic decompression combined with oblique lumbar interbody fusion is an effective, safe surgical technique for lumbar spinal stenosis with prolapsed nucleus pulposus.