{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:35Z","timestamp":1792787255695,"version":"4.5.0"},"reference-count":37,"publisher":"BMJ","issue":"9","funder":[{"name":"Patient-Centered Clinical Research Coordinating Center (PACEN), Ministry of Health & Welfare, Republic of Korea","award":["RS-2025-02216840"],"award-info":[{"award-number":["RS-2025-02216840"]}],"id":[{"id":"https:\/\/ror.org\/00vxgjw72","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,28]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Degenerative lumbar spine disease is common in the elderly, but spinal fusion is often avoided in patients over 90 years due to perceived risks of surgical or anaesthesia-related complications. Full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) via the trans-Kambin approach offers a minimally invasive alternative that can be performed without general anaesthesia. We report a nonagenarian patient with recurrent symptomatic foraminal stenosis at L4\u2013L5 after prior decompression surgeries who underwent FE-TLIF under local anaesthesia. The procedure was well tolerated, with significant pain relief, early mobilisation and radiological evidence of initial fusion at 10 months follow-up. This case illustrates that age alone should not be considered an absolute contraindication for spinal fusion. Surgical decision-making should prioritise physiological rather than chronological age, and in experienced hands, endoscopic spinal fusion may represent a safe and effective treatment option even in carefully selected nonagenarians.<\/jats:p>","DOI":"10.1136\/bcr-2025-269723","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:40:30Z","timestamp":1790239230000},"page":"e269723","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Awake full-endoscopic transforaminal lumbar interbody fusion via the trans-Kambin approach under local anaesthesia in a nonagenarian"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8049-9750","authenticated-orcid":false,"given":"Maria","family":"Auron","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Seoul St Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seocho-gu, 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