# How I do it: dual operation channels percutaneous endoscopic far-lateral transforaminal lumbar interbody fusion

## TL;DR

A new endoscopic surgical technique is introduced for lumbar spine fusion that uses two channels to improve efficiency and reduce complications.

## Contribution

A novel dual-channel percutaneous endoscopic method for far-lateral transforaminal lumbar interbody fusion is presented.

## Key findings

- The dual-channel endoscopic approach allows efficient removal of articular processes and ligamentum flavum.
- The method enables successful interbody bone grafting and cage placement with reduced radiation exposure.
- This technique avoids endplate damage and achieves successful lumbar fusion.

## Abstract

The current surgical procedure of interbody fusion in the lumbar spine has several limitations including low efficiency, potential endplate damage, overdose radiation exposure, and failure of fusion.

Through the endoscopic operating channel, we efficiently removed the superior and inferior articular processes and decompressed the ligamentum flavum. Another operating channel was established under endoscopic monitoring to excise the annulus fibrosus, remove the cartilaginous endplate using open instruments, perform interbody bone grafting, and place a non-expandable polyetheretherketone open surgical fusion cage.

Lumbar interbody fusion was performed successfully using a far-lateral transforaminal approach combined with dual operation channels of percutaneous endoscopic-assisted technique.

The online version contains supplementary material available at 10.1007/s00701-024-05946-x.