Endoscopic Posterior Lumbar Interbody Fusion (PLIF)

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.