Therapeutic efficacy of endoscopic lumbar interbody fusion in patients with lumbar instability and analysis of prognostic factors
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To evaluate the therapeutic efficacy of endoscopic lumbar interbody fusion (ELIF) in the management of lumbar instability and identify potential prognostic factors. METHODS: A retrospective analysis was conducted on 278 patients treated for lumbar instability at Baoji Hospital of Traditional Chinese Medicine between February 2021 and November 2023. Based on treatment approach, the patients were divided into two arms: ELIF group (n=141) and posterior lumbar interbody fusion (PLIF) group (n=137). Comparisons were conducted across multiple clinical metrics including operation time, intraoperative hemorrhage volume, duration of postoperative hospitalization, and functional-pain-related assessments such as VAS (visual analogue scale), ODI (Oswestry Disability Index), and JOA (Japanese Orthopedic Association) scores. Additional imaging outcomes (e.g., lumbar lordosis, degree of spondylolisthesis, and dural cross-sectional area) were also evaluated. JOA improvement over a 12-month period was the primary follow-up indicator. Multivariate logistic regression analysis was employed to identify prognostic risk factors. RESULTS: ELIF was associated with significantly reduced surgical duration, less intraoperative blood loss, and faster postoperative recovery (P<0.05). Postoperatively, ELIF patients exhibited significantly lower VAS and ODI scores and higher JOA score (P<0.05). Radiographic improvements in sagittal balance (lumbar lordosis), vertebral alignment (spondylolisthesis), and neural decompression (dural area) were more pronounced in the ELIF group (P<0.05). One year post-surgery, the JOA score improvement in the ELIF group remained superior. However, advanced age (≥60 years), diabetes, severe preoperative spondylolisthesis (≥ grade II), and baseline JOA <10 were independently associated with suboptimal outcomes. CONCLUSION: ELIF is an effective approach for treating lumbar instability, offering advantages in efficiency, functional recovery, and postoperative rehabilitation. Identifying key prognostic factors may refine clinical decision-making and optimize perioperative strategies for improved outcomes.
DOI: 10.62347/uars9841
Author: Junfeng Wang
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4415725857
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