Endoscopic Posterior Lumbar Interbody Fusion (PLIF) is a minimally
invasive surgical technique to fuse the lumbar vertebrae. This approach combines
endoscopy with the established PLIF procedure, reducing tissue damage, improving
visualization, and direct neural decompression. The smaller incision size, precise
visualization, and specialized endoscopic tools contribute to decreased postoperative
pain, faster recovery, and potentially improved patient outcomes. In this chapter, the
authors highlight the technical pearls of the endoscopic PLIF by going through the
surgery step-by-step with illustrative clinical and intraoperative examples. The authors
encourage novice surgeons to obtain specialized training and the necessary equipment
to mitigate the potential risks and complications, including damage to neural elements,
spinous process fractures, and implant-related problems. While the clinical examples
presented herein had excellent functional outcomes and considerable reductions in
preoperative pain levels, further research is needed to evaluate the long-term efficacy
and outcomes of endoscopic PLIF compared to traditional open procedures.
Keywords: Endoscopic lumbar surgery, Posterior lumbar interbody fusion, Technique, Unilateral access, Bilateral decompression.
