• World Neurosurg · Apr 2020

    Case Reports

    Awake, Endoscopic Revision Surgery for Lumbar Pseudarthrosis after TLIF: Technical Note.

    • Albert E Telfeian, Krisztina Moldovan, Elias Shaaya, Sohail Syed, Adetokunbo Oyelese, Jared Fridley, and Ziya L Gokaslan.
    • The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. Electronic address: atelfeian@lifespan.org.
    • World Neurosurg. 2020 Apr 1; 136: 117-121.

    ObjectiveWe sought to evaluate the feasibility for awake, endoscopic treatment of lumbar pseudarthrosis after a transforaminal lumbar interbody fusion (TLIF).MethodsA 71-year-old male with severe cardiac disease, determined to be high risk for general anesthesia, presented with mechanical back pain and a L3-4 pseudarthrosis and L3 pedicle screw loosening after a L3-5 TLIF. An awake, transforaminal endoscopic redo diskectomy and TLIF procedure were performed by removing residual disk material adjacent to the previous "PEEK" (polyetheretherketone) interbody spacer and placing allograft, bone morphogenetic protein, and an expandable titanium interbody device adjacent to the PEEK cage.ResultsAt 1-year follow-up, preoperative visual analog scale for back pain and Oswestry disability index improved from 7 and 38% to 1 and 2%. The 1-year follow-up radiograph showed stable interbody placement and no further screw loosening.ConclusionsA minimally invasive, awake procedure is presented for the treatment of pseudarthrosis after TLIF.Copyright © 2020 Elsevier Inc. All rights reserved.

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