Innovative method for efficient placement of a working cannula in uniportal transarticular full-endoscopic lumbar interbody fusion: transarticular trephonic plasty (TTP).

PURPOSE: To evaluate the safety and efficiency of a novel transarticular trephonic plasty (TTP) technique for establishing the working cannula in uniportal transarticular full-endoscopic lumbar interbody fusion (Endo-LIF).

METHODS

A total of 79 patients with single-level lumbar degenerative disease who underwent uniportal transarticular Endo-LIF were retrospectively divided into two groups: the traditional technique (TT) group and the TTP group. The TTP group underwent cannula placement using the new TTP approach, whereas the TT group used the conventional method. Operation time and fluoroscopy exposure during cannula placement, total surgical time, and early postoperative complications were recorded. Clinical outcomes were assessed using the visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) at 3 days, 3 months, and 12 months postoperatively.

RESULTS

The TTP group showed significantly shorter cannula placement time compared with the TT group (11.4 ± 5.1 min vs. 31.5 ± 9.4 min, p < 0.000). Total surgical time was also shorter in the TTP group (135.7 ± 16.3 min vs. 163.1 ± 23.3 min, p < 0.000). However, fluoroscopy exposure was lower in the TT group. Complication rates were low and did not differ significantly between groups (p > 0.05). Both groups exhibited significant improvements in VAS and ODI scores at all postoperative time points relative to preoperative baselines, with no significant differences observed between groups (p > 0.05).

CONCLUSION

The TTP technique is a safe and efficient method for establishing the working cannula in uniportal transarticular Endo-LIF. It improves surgical efficiency without compromising safety and may help reduce the technical threshold for surgeons, thereby facilitating wider adoption of uniportal transarticular Endo-LIF as a minimally invasive treatment for lumbar degenerative disease.