Percutaneous biportal endoscopic TLIF with an ERAS pathway significantly reduced estimated blood loss (190.3 ml vs 289.3 ml) and early postoperative back pain compared to microscopic TLIF without ERAS.
Cohort (n=69)
No
Does percutaneous biportal endoscopic TLIF with an ERAS pathway improve postoperative pain and reduce bleeding compared to microscopic TLIF without ERAS in patients undergoing single-level lumbar fusion?
Percutaneous biportal endoscopic TLIF combined with an ERAS pathway reduces estimated blood loss and early postoperative back pain compared to microscopic TLIF without ERAS, despite requiring a longer operative time.
Absolute Event Rate: 190.3% vs 289.3%
p-value: p=<0.05
OBJECTIVEThe aims of enhanced recovery after surgery (ERAS) are to improve surgical outcomes, shorten hospital stays, and reduce complications. The objective of this study was to introduce ERAS with biportal endoscopic transforaminal lumbar interbody fusion (TLIF) and to investigate the clinical results.METHODSPatients were divided into two groups based on the fusion procedures. Patients who received microscopic TLIF without ERAS were classified as the non-ERAS group, whereas those who received percutaneous biportal endoscopic TLIF with ERAS were classified as the ERAS group. The mean Oswestry Disability Index (ODI) and visual analog scale (VAS) scores were compared between the two groups. In addition, demographic characteristics, diagnosis, mean operative time, estimated blood loss (EBL), fusion rate, readmissions, and complications were investigated and compared.RESULTSForty-six patients were grouped into the non-ERAS group (microscopic TLIF without ERAS) and 23 patients into the ERAS group (biportal endoscopic TLIF with ERAS). The VAS score for preoperative back pain on days 1 and 2 was significantly higher in the non-ERAS group than in the ERAS group (p 0.05). Readmission was required in 2 patients who were from the non-ERAS group. Postoperative complications occurred in 6 cases in the non-ERAS group and in 2 cases in the ERAS group.CONCLUSIONSPercutaneous biportal endoscopic TLIF with an ERAS pathway may have good aspects in reducing bleeding and postoperative pain. Endoscopic fusion surgery along with the ERAS concept may help to accelerate recovery after surgery.
Heo et al. (Mon,) conducted a cohort in Lumbar degenerative disease (n=69). Percutaneous biportal endoscopic TLIF with ERAS vs. Microscopic TLIF without ERAS was evaluated on Estimated blood loss (ml) (p=<0.05). Percutaneous biportal endoscopic TLIF with an ERAS pathway significantly reduced estimated blood loss (190.3 ml vs 289.3 ml) and early postoperative back pain compared to microscopic TLIF without ERAS.
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