• Kang Li, Ting-Zhen Yan, Zi-Ang Lu, Ling-Hao Wang, Yan-Ke Hao, and Chao-Liang Lv.
• Shandong University of Traditional Chinese Medicine Postdoctoral Research Station, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, P.R. China; Department of Spine Surgery, Jining No.1 People's Hospital, Jining, Shandong Province, P.R. China.
• World Neurosurg. 2022 Nov 1; 167: e1253e1260e1253-e1260.

PurposeIn this study, a large diameter visible trephine was designed and used in percutaneous endoscopic lumbar interbody fusion to increase endoscopic bone decompression efficiency. Large diameter visible trephine-related technical notes and preliminary clinical experience are described.MethodsA large diameter visible trephine was designed with normal diameter visible trephine as template. A total of 38 patients with lumbar degenerative diseases who underwent single-level percutaneous endoscopic lumbar interbody fusion with large or normal diameter visible trephine were included into a retrospective study. Operation time, bone decompression time, blood loss, intraoperative fluoroscopy, bone decompression fluoroscopy, and dura or nerve injury cases were recorded and analyzed statistically. Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) were used to analyze the clinical outcomes of the 2 groups.ResultsThe baseline data of the 2 groups were statistically similar. There was no significant difference in postoperative VAS and ODI scores between the 2 groups. Operation time and bone decompression time of large diameter visible trephine group were significantly shorter than that of normal diameter visible trephine group (P < 0.05). Intraoperative fluoroscopy times and bone decompression fluoroscopy times of large diameter visible trephine group were significantly more than that of normal diameter visible trephine group (P < 0.05). Blood loss of the 2 groups were not statistically different. There were no dura or nerve injury cases in the 2 groups.ConclusionsFor percutaneous endoscopic lumbar interbody fusion, the large diameter visible trephine is a safe and efficient endoscopic bone decompression tool under fluoroscopic guidance.Copyright © 2022 Elsevier Inc. All rights reserved.

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