Clinical outcomes and radiologic parameters of percutaneous endoscopic posterior/transforaminal lumbar interbody fusion using rammed-earth technique.

Introduction: To assess the clinical effectiveness of employing rammed-earth technique in bone grafting during percutaneous endoscopic posterior/transforaminal lumbar interbody fusion (PE-P/TLIF) in treating lumbar degenerative diseases. Methods: This retrospective study analyzed patients who underwent PE-P/TLIF for lumbar degenerative diseases from December 2019 to August 2023. The study included 22 patients treated with the rammed-earth technique and 21 patients treated without the rammed-earth technique. Surgical time, intraoperative blood loss, and the number of surgical segments were compared between the two groups. Pain and neurological function were evaluated using the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and the Japanese Orthopaedic Association (JOA) lumbar score. Radiographic measurements, including lumbar lordosis, segmental lordosis, intervertebral height, and cage subsidence depth. Results: Both groups showed varying degrees of reduction in VAS and ODI scores from preoperative levels on the first postoperative day and at the final follow-up, while the JOA scores increased significantly. At the final follow-up, the rammed group had higher JOA ratings than the umrammed group. ( Conclusion: Using the rammed-earth technique in PE-P/TLIF procedures can securely reduce the rate and depth of cage subsidence, improving lumbar spine function after a follow-up period of at least six months.