Initial Experience with Unilateral Dual Portal Endoscopic TLIF Utilizing Dual Direction Expandable Cages: A Preliminary Case Series

Introduction: Unilateral Dual Portal Endoscopic Transforaminal Lumbar Interbody Fusion (UDPE-TLIF) is a minimally invasive surgical technique gaining traction in the management of degenerative lumbar spine conditions. This study presents the initial experience and outcomes of UDPE-TLIF utilizing Dual Direction Expandable Cages through a preliminary case series.

Methods: A series of consecutive patients who underwent UDPE-TLIF at Ain Al Khaleej Hospital were retrospectively analyzed. Demographic information, preoperative clinical status, and radiological assessments were recorded. Clinical outcomes, including pain relief and functional improvement, were evaluated using standardized measures such as the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological outcomes, including fusion rates and changes in disc height and neural foraminal height, were assessed through imaging studies. Descriptive statistics were used to summarize the data.

Results: Six patients underwent UDPE-TLIF utilizing Dual Direction Expandable Cages. Preliminary results demonstrate promising outcomes. Patients experienced significant pain reduction and improved functional status postoperatively, the VAS score for back pain decreased from 7.7±1 to 4±2, while the perioperative VAS score for leg pain improved from 8.2±0.9 to 3±2.1and ODI improved from 59±5.8 to 27.5±15. Radiologically, there were notable improvements in disc height from 5.6±1.5 mm to 15.8±0.6 mm (p < 0.05) and neural foraminal height from 8.8±4 mm to 16.8±3.4 mm (p < 0.05), indicating successful restoration of lumbar spine anatomy. Fusion rates were satisfactory.

Conclusion :: This preliminary case series highlights the initial experience with UDPE-TLIF using Dual Direction Expandable Cages. The technique appears to offer favorable clinical and radiological outcomes, suggesting its potential as a minimally invasive option for the treatment of degenerative lumbar spine conditions. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings and establish the safety and efficacy of UDPE-TLIF in a broader patient population.