{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T03:10:39Z","timestamp":1792638639895,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Severe collapsed disc secondary to degenerative spinal conditions leads to significant foraminal stenosis. We hypothesized that uniportal posterolateral transforaminal lumbar interbody fusion with endoscopic disc drilling technique could be safely applied to the collapsed disc space to improve patients\u2019 pain score, restore disc height, and correct the segmental angular parameters. Methods: We included patients who met the indication criteria for lumbar fusion and underwent uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion with pre-operative Computer Tomography mid disc height of less than or equal to 5 mm and MRI of Grade 3 Foraminal Stenosis. Visual analogue scale and computer tomography pre-operative and post-operative sagittal disc height in the anterior, middle and posterior part of the disc; sagittal focal segmental angle; mid coronal disc height and coronal wedge angles were evaluated. Results: 30 levels of Endo-TLIF were included, with a mean follow up of 12 months. The mean improvement in decreasing pain score was 2.5 \u00b1 1.1, 3.2 \u00b1 0.9 and 4.3 \u00b1 1.0 at 1 week post operation, 3 months post operation and at final follow up, respectively, p &lt; 0.05. There was significant increase in mid sagittal computer tomographic anterior, middle and posterior disc height of 6.99 \u00b1 2.30, 6.28 \u00b1 1.44, 5.12 \u00b1 1.79 mm respectively, p &lt; 0.05. CT mid coronal disc height showed an increase of 7.13 \u00b1 1.90 mm, p &lt; 0.05. There was a significant improvement in the CT coronal wedge angle of 2.35 \u00b1 4.73 and the CT segmental focal sagittal angle of 1.98 \u00b1 4.69, p &lt; 0.05. Conclusion: Application of Uniportal Endoscopic Posterolateral Lumbar Interbody Fusion in patients with severe foraminal stenosis secondary to severe collapsed disc space significantly relieved patients\u2019 pain and restored disc height without early subsidence or exiting nerve root dysesthesia in our cohort of patients.<\/jats:p>","DOI":"10.3390\/brainsci10060373","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T12:16:57Z","timestamp":1592223417000},"page":"373","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion with Endoscopic Disc Drilling Preparation Technique for Symptomatic Foraminal Stenosis Secondary to Severe Collapsed Disc Space: A Clinical and Computer Tomographic Study with Technical Note"],"prefix":"10.3390","volume":"10","author":[{"given":"Pang Hung","family":"Wu","sequence":"first","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"},{"name":"National University Health System, JurongHealth Campus, Orthopaedic Surgery, Singapore 609606, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5361-5234","authenticated-orcid":false,"given":"Hyeun Sung","family":"Kim","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeon Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Bok","family":"Jeon","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshavardhan Dilip","family":"Raorane","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il-Tae","family":"Jang","sequence":"additional","affiliation":[{"name":"Spine Surgery, Nanoori Gangnam Hospital, Seoul 06048, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990\u20132010: A systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wu, P.H., Kim, H.S., and Jang, I.-T. (2020). Intervertebral Disc Diseases PART 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21062135"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.2106\/JBJS.H.00913","article-title":"Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis: Four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts","volume":"91","author":"Weinstein","year":"2009","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_4","first-page":"e3135","article-title":"Comparison of Decompression Alone versus Decompression with Fusion for Stenotic Lumbar Spine: A Systematic Review and Meta-analysis","volume":"10","author":"Ahmed","year":"2018","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6","DOI":"10.14245\/ns.1836322.161","article-title":"Evolution of Spinal Endoscopic Surgery","volume":"16","author":"Kim","year":"2019","journal-title":"Neurospine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/BSD.0b013e318175ddb4","article-title":"Recurrent lumbar disc herniation after conventional discectomy: A prospective, randomized study comparing full-endoscopic interlaminar and transforaminal versus microsurgical revision","volume":"22","author":"Ruetten","year":"2009","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1586\/17434440.2014.940314","article-title":"Percutaneous endoscopic decompression for lumbar spinal stenosis","volume":"11","author":"Ahn","year":"2014","journal-title":"Expert Rev. Med. Devices"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00701-019-04157-z","article-title":"How I do it? Uniportal full endoscopic contralateral approach for lumbar foraminal stenosis with double crush syndrome","volume":"162","author":"Wu","year":"2019","journal-title":"Acta Neurochir."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.14245\/ns.1836320.160","article-title":"Step-by-Step Sublaminar Approach with a Newly-Designed Spinal Endoscope for Unilateral-Approach Bilateral Decompression in Spinal Stenosis","volume":"16","author":"Ito","year":"2019","journal-title":"Neurospine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/BSD.0b013e3182064614","article-title":"Usefulness of an expandable interbody spacer for the treatment of foraminal stenosis in extremely collapsed disks: Preliminary clinical experience with endoscopic posterolateral transforaminal approach","volume":"24","author":"Morgenstern","year":"2011","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.3171\/2015.11.FOCUS15435","article-title":"Endoscopic minimally invasive transforaminal interbody fusion without general anesthesia: Initial clinical experience with 1-year follow-up","volume":"40","author":"Wang","year":"2016","journal-title":"Neurosurg. Focus"},{"key":"ref_12","first-page":"e745","article-title":"Fully Endoscopic Lumbar Laminectomy and Transforaminal Lumbar Interbody Fusion under Local Anesthesia with Conscious Sedation: A Case Series","volume":"127","author":"Shen","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00064-006-0085-6","article-title":"Dorsale Repositionsspondylodese bei lumbalen Spondylolisthesis","volume":"11","author":"Harms","year":"1999","journal-title":"Oper. Orthop\u00e4die Traumatol."},{"key":"ref_14","first-page":"E8","article-title":"Fully endoscopic lumbar interbody fusion using a percutaneous unilateral biportal endoscopic technique: Technical note and preliminary clinical results","volume":"43","author":"Heo","year":"2017","journal-title":"Biomed. Res. Int."},{"key":"ref_15","first-page":"373","article-title":"Endoscopic transforaminal lumbar interbody fusion: A comprehensive review","volume":"16","author":"Son","year":"2019","journal-title":"Neurosurg. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100712","DOI":"10.1016\/j.inat.2020.100712","article-title":"Technical note on Uniportal full endoscopic posterolateral approach transforaminal lumbar interbody fusion with reduction for grade 2 spondylolisthesis","volume":"21","author":"Kim","year":"2020","journal-title":"Interdiscip. Neurosurg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2214\/AJR.09.2772","article-title":"A practical MRI grading system for lumbar foraminal stenosis","volume":"194","author":"Lee","year":"2010","journal-title":"Am. J. Roentgenol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/S1050-6411(03)00044-0","article-title":"Clinical spinal instability and low back pain","volume":"13","author":"Panjabi","year":"2003","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"49","DOI":"10.2176\/nmc.oa.2017-0121","article-title":"Clinical and Radiological Outcomes of Microscopic Lumbar Foraminal Decompression: A Pilot Analysis of Possible Risk Factors for Restenosis","volume":"58","author":"Haimoto","year":"2018","journal-title":"Neurol. Med.-Chir."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kim, H.S., Raorane, H.D., Hung, W.P., Heo, D.H., Sharma, S.B., and Jang, I.T. (2020). Incidental Durotomy during Endoscopic Stenotic Lumbar Decompression (ESLD): Incidence, classification and proposed management strategies. World Neurosurg.","DOI":"10.1016\/j.wneu.2020.01.242"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ijsp.2012.04.001","article-title":"Endoscopic transforaminal decompression, interbody fusion, and percutaneous pedicle screw implantation of the lumbar spine: A case series report","volume":"6","author":"Osman","year":"2012","journal-title":"Int. J. Spine Surg."},{"key":"ref_22","first-page":"e401","article-title":"Percutaneous Endoscopic Lumbar Discectomy for All Types of Lumbar Disc Herniations (LDH) Including Severely Difficult and Extremely Difficult LDH Cases","volume":"21","author":"Kim","year":"2018","journal-title":"Pain Physician"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/S1008-1275(08)60047-4","article-title":"Endoscopic transforaminal lumbar decompression, interbody fusion and pedicle screw fixation\u2014A report of 42 cases","volume":"11","author":"Zhou","year":"2008","journal-title":"Chin. J. Traumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.3171\/2018.12.FOCUS18701","article-title":"Endoscopic transforaminal lumbar interbody fusion without general anesthesia: Operative and clinical outcomes in 100 consecutive patients with a minimum 1-year follow-up","volume":"46","author":"Kolcun","year":"2019","journal-title":"Neurosurg. Focus"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1007\/s00264-013-1905-6","article-title":"Percutaneous endoscopic transforaminal lumbar interbody fusion: Is it worth it?","volume":"37","author":"Jacquot","year":"2013","journal-title":"Int. Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"248","DOI":"10.4055\/cios.2018.10.2.248","article-title":"Biportal Endoscopic Transforaminal Lumbar Interbody Fusion with Arthroscopy","volume":"10","author":"Kim","year":"2018","journal-title":"Clin. Orthop. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/00007632-200001150-00006","article-title":"Load-sharing characteristics of stabilized lumbar spine segments","volume":"25","author":"Cripton","year":"2000","journal-title":"Spine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/BSD.0000000000000827","article-title":"Full Percutaneous Transforaminal Lumbar Interbody Fusion Using the Facet-sparing, Trans-Kambin Approach","volume":"33","author":"Morgenstern","year":"2019","journal-title":"Clin. Spine Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.1097\/BSD.0000000000000089","article-title":"Learning curve of a complex surgical technique: Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF)","volume":"27","author":"Lee","year":"2014","journal-title":"J. Spinal Disord. Tech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e578","DOI":"10.1016\/j.wneu.2020.01.080","article-title":"Dural Tears in Percutaneous Biportal Endoscopic Spine Surgery: Anatomical Location and Management","volume":"136","author":"Park","year":"2020","journal-title":"World Neurosurg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"63","DOI":"10.14245\/ns.1938048.024","article-title":"Percutaneous Endoscopic Decompression in Lumbar Canal and Lateral Recess Stenosis\u2014The Surgical Learning Curve","volume":"16","author":"Lee","year":"2019","journal-title":"Neurospine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"131","DOI":"10.14245\/ns.1836046.023","article-title":"Feasibility of Full Endoscopic Spine Surgery in Patients over the Age of 70 Years with Degenerative Lumbar Spine Disease","volume":"15","author":"Kim","year":"2018","journal-title":"Neurospine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1097\/BRS.0000000000002708","article-title":"Efficacy and Safety of Full-endoscopic Decompression via Interlaminar Approach for Central or Lateral Recess Spinal Stenosis of the Lumbar Spine: A Meta-analysis","volume":"43","author":"Lee","year":"2018","journal-title":"Spine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"602","DOI":"10.3171\/2015.7.SPINE15304","article-title":"Percutaneous biportal endoscopic decompression for lumbar spinal stenosis: A technical note and preliminary clinical results","volume":"24","author":"Son","year":"2016","journal-title":"J. Neurosurg. Spine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.wneu.2017.03.130","article-title":"Percutaneous Full Endoscopic Bilateral Lumbar Decompression of Spinal Stenosis through Uniportal-Contralateral Approach: Techniques and Preliminary Results","volume":"103","author":"Kim","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.wneu.2017.01.079","article-title":"Contralateral interlaminar keyhole percutaneous endoscopic surgery in patients with unilateral radiculopathy: Technical notes","volume":"101","author":"Hwang","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.3171\/2019.2.FOCUS195","article-title":"Comparison of full-endoscopic and minimally invasive decompression for lumbar spinal stenosis in the setting of degenerative scoliosis and spondylolisthesis","volume":"46","author":"Hasan","year":"2019","journal-title":"Neurosurg. Focus"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.wneu.2018.05.251","article-title":"Management of Dural Tears in Endoscopic Lumbar Spinal Surgery: A Review of the Literature","volume":"119","author":"Muller","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"21","DOI":"10.14444\/1021","article-title":"Transforaminal endoscopic lumbar decompression & foraminoplasty: A 10 year prospective survivability outcome study of the treatment of foraminal stenosis and failed back surgery","volume":"8","author":"Knight","year":"2014","journal-title":"Int. J. Spine Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4184\/asj.2018.12.2.309","article-title":"Comparative Prospective Study Reporting Intraoperative Parameters, Pedicle Screw Perforation, and Radiation Exposure in Navigation-Guided versus Non-navigated Fluoroscopy-Assisted Minimal Invasive Transforaminal Lumbar Interbody Fusion","volume":"12","author":"Dusad","year":"2018","journal-title":"Asian Spine J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.wneu.2017.06.174","article-title":"Minimally Invasive Computer Navigation-Assisted Endoscopic Transforaminal Interbody Fusion with Bilateral Decompression via a Unilateral Approach: Initial Clinical Experience at One-Year Follow-Up","volume":"106","author":"Zhang","year":"2017","journal-title":"World Neurosurg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s00264-016-3281-5","article-title":"Navigation improves the learning curve of transforamimal percutaneous endoscopic lumbar discectomy","volume":"41","author":"Fan","year":"2017","journal-title":"Int. Orthop."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.3171\/2009.12.FOCUS09259","article-title":"Osteotomies in the posterior-only treatment of complex adult spinal deformity: A comparative review","volume":"28","author":"Ian","year":"2010","journal-title":"Neurosurg. Focus"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/6\/373\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:39:12Z","timestamp":1760175552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/6\/373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,15]]},"references-count":43,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["brainsci10060373"],"URL":"https:\/\/doi.org\/10.3390\/brainsci10060373","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,15]]}}}