Percutaneous posterior lumbar interbody fusion using the B-Twin expandable spinal spacer

Sixty-two suitable subjects (mean age: 49.3 years) underwent percutaneous posterior lumbar interbody fusion (PPLIF) using the B-Twin expandable spinal spacer (B-Twin ESS) and were followed thereafter for 2 years or longer. The clinical outcome was expressed by the change in pain intensity as scored on a visual analogue scale and the change in degree of disability as scored by the Oswestry Disability Index. The results were compared with those of a previous trial of PLIF using the B-Twin ESS in which the latter was introduced via the open surgical approach (OPLIF). Mean duration of operation was 103 minutes. Blood loss was negligible. No operative difficulties or complications were encountered. No participant was lost to follow-up. Disc space height had increased by a mean of 10%. At that time there were no radiographic signs of non-union in any patient. The mean pain intensity and disability scores decreased by 66% and 61%, respectively, as compared to those on admission. The clinical outcome of the percutaneous method was comparable to that of the open procedure using the B-Twin ESS; however, the results can be interpreted as favoring the former in the context of minimal invasiveness. Should this outcome be validated in further trials, the technique may be adopted in selective cases.