Procedure

Endoscopic Spinal Fusion

Endoscopic spinal fusion combines the decompressive accuracy of endoscopy with percutaneous instrumentation to achieve stable lumbar fusion through incisions measuring just 7–18 mm.

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Overview

About This Procedure

Endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) is an evolution of standard MIS-TLIF, performing the interbody portion entirely through a full-endoscopic portal before supplementing with percutaneous pedicle screws. This approach achieves complete disc space preparation, interbody cage insertion, and fusion without the muscle damage of conventional open fusion. It is particularly suited for degenerative spondylolisthesis, disc degeneration causing chronic pain, and isthmic spondylolisthesis. Dr. Sparsh Jaiswal applies this technique to achieve fusion results comparable to open surgery with the recovery profile of endoscopic decompression.

Indications

check_circleDegenerative lumbar spondylolisthesis causing stenosis and instability
check_circleIsthmic spondylolisthesis in active patients
check_circleSevere discogenic back pain with Modic endplate changes after failed conservative treatment
check_circleAdjacent segment disease after prior lumbar fusion
check_circleLumbar disc herniation with concurrent instability

Step-by-Step Procedure

Percutaneous Screw Placement

Four percutaneous pedicle screws placed bilaterally under fluoroscopic guidance through 18 mm incisions — one per screw site.

Endoscopic Disc Preparation

Through a 7 mm endoscopic portal, the disc space is thoroughly cleared of nucleus material, and the endplates are prepared to bleeding bone for fusion.

Cage & Graft Insertion

An appropriately sized PEEK or titanium interbody cage packed with bone graft (autologous or synthetic) is inserted endoscopically to restore disc height and achieve fusion.

Rod Passage & Finalisation

Connecting rods are passed percutaneously through the screw heads and tightened under fluoroscopic confirmation. Final imaging confirms alignment and construct position.

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What to Expect

Surgery takes 2–3 hours. Patients mobilise on post-operative day 1. Mild incision soreness resolves within 1–2 weeks. Fusion consolidation takes 3–6 months and is monitored with CT imaging.

healing

Recovery

Hospital stay is 2–3 days. A lightweight lumbar support may be worn for 4–6 weeks. Return to desk work in 2–3 weeks; manual work in 8–12 weeks. Physiotherapy-based rehabilitation from week 3.