{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:33:26Z","timestamp":1790282006588,"version":"4.1.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>One of the principal goals of minimally invasive surgery has been to speed postoperative recovery. In this case series, the authors used an endoscopic technique for interbody fusion combined with percutaneous screw fixation to obviate the need for general anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The first 10 consecutive patients treated with a minimum of 1 year's follow-up were included in this series. The patients were all treated using endoscopic access through Kambin's triangle to allow for neural decompression, discectomy, endplate preparation, and interbody fusion. This was followed by percutaneous pedicle screw and connecting rod placement using liposomal bupivacaine for long-acting analgesia. No narcotics or regional anesthetics were used during surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>All patients underwent the procedure successfully without conversion to open surgery. The patients' average age was 62.2 \u00b1 9.0 years (range 52\u201378 years). All patients had severe disc height collapse, and 60% had a Grade I spondylolisthesis. The mean operative time was 113.5 \u00b1 6.3 minutes (range 105\u2013120 minutes), and blood loss was 65 \u00b1 38 ml (range 30\u2013190 ml). The mean length of hospital stay was 1.4 \u00b1 1.3 nights. There were no intraoperative or postoperative complications. Comparison of preoperative and final clinical metrics demonstrated that the Oswestry Disability Index improved from 42 \u00b1 11.8 to 13.3 \u00b1 15.1; the 36-Item Short Form Health Survey (SF-36) Physical Component Summary improved from 47.6 \u00b1 3.8 to 49.7 \u00b1 5.4; the SF-36 Mental Component Summary decreased from 47 \u00b1 3.9 to 46.7 \u00b1 3.4; and the EQ-5D improved from 10.7 \u00b1 9.5 to 14.2 \u00b1 1.6. There were no cases of nonunion identified radiographically on follow-up imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Endoscopic fusion under conscious sedation may represent a feasible alternative to traditional lumbar spine fusion in select patients. Larger clinical series are necessary to validate that clinical improvements are sustained and that arthrodesis rates are successful when compared with open surgery. This initial experience demonstrates the possible utility of this procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.11.focus15435","type":"journal-article","created":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T03:36:55Z","timestamp":1454297815000},"page":"E13","source":"Crossref","is-referenced-by-count":210,"title":["Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: initial clinical experience with 1-year follow-up"],"prefix":"10.3171","volume":"40","author":[{"given":"Michael Y.","family":"Wang","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Grossman","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15435","series-title":"Spine (Phila Pa 1976)","first-page":"1131","article-title":"Intrathecal morphine. Double-blind evaluation of optimal dosage for analgesia after major lumbar spinal surgery","volume":"24","author":"Boezaart","year":"1999"},{"key":"b2-focus15435","series-title":"Spine (Phila Pa 1976)","first-page":"E36","article-title":"Feasibility and patient-reported outcomes after outpatient single-level instrumented posterior lumbar interbody fusion in a surgery center: preliminary results in 16 patients","volume":"40","author":"Chin","year":"2015"},{"key":"b3-focus15435","series-title":"Clin Orthop Relat Res","first-page":"1806","article-title":"Same-day discharge after minimally invasive transforaminal lumbar interbody fusion: a series of 808 cases","volume":"472","author":"Eckman","year":"2014"},{"key":"b4-focus15435","series-title":"Spine (Phila Pa 1976)","first-page":"210","article-title":"Postoperative continuous para-vertebral anesthetic infusion for pain control in lumbar spinal fusion surgery","volume":"33","author":"Elder","year":"2008"},{"key":"b5-focus15435","series-title":"Neurosurgery","first-page":"1512","article-title":"Minimally invasive percutaneous posterior lumbar interbody fusion","volume":"52","author":"Fessler","year":"2003"},{"key":"b6-focus15435","series-title":"Spine (Phila Pa 1976)","first-page":"536","article-title":"Percutaneous placement of posterior cervical screws using three-dimensional fluoroscopy","volume":"31","author":"Holly","year":"2006"},{"key":"b7-focus15435","series-title":"Int Orthop","first-page":"62","article-title":"Preincisional caudal epidural blockade and the relief of pain after lumbar spine operations","volume":"21","author":"Kakiuchi","year":"1997"},{"key":"b8-focus15435","series-title":"Can J Anaesth Soc J","first-page":"149","article-title":"Epidural anesthesia for lumbar laminectomy and spinal fusion","author":"Matheson","year":"1960"},{"key":"b9-focus15435","series-title":"World Neurosurg","first-page":"230","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis","volume":"82","author":"Parker","year":"2014"},{"key":"b10-focus15435","series-title":"Spine (Phila Pa 1976)","first-page":"1799","article-title":"Who should undergo surgery for degenerative spondylolisthesis? 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