Minim Invasive Neurosurg 2007; 50(3): 150-154
DOI: 10.1055/s-2007-985144
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Balloon-Assisted Endoscopic Retroperitoneal Gasless Approach (BERG) for Lumbar Interbody Fusion: Is it a Valid Alternative to the Laparoscopic Approach?

R. Gazzeri 1 , M. Tamorri 2 , M. Galarza 3 , A. Faiola 2 , G. Gazzeri 2
  • 1Department of Neurosurgery, San Giovanni Addolorata Hospital, Rome, Italy
  • 2Department of Neurosurgery, San Filippo Neri Hospital, Rome, Italy
  • 3Department of Neurosurgery, Villa Maria Cecilia Hospital, Ravenna, Italy
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Publication History

Publication Date:
19 September 2007 (online)

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Abstract

Objective: In the last years the use of interbody fusion devices with an anterior spinal lumbar approach has become a common procedure for the treatment of degenerative disc disease and spinal instability. We analysed our series of a simplified endoscopic approach to the anterior spine and made a review of the retroperitoneal endoscopically assisted approach to the anterior lumbar spine in the international literature.

Methods and Results: From 1999 through 2002, twenty consecutive “balloon-assisted endoscopic retroperitoneal gasless (BERG)” lumbar fusions were performed at San Filippo Neri Hospital in Rome, Italy. The surgical indications included patients with grade I or II spondylolisthesis and symptomatic degenerative disc disease with foraminal stenosis. Fourteen patients underwent a single level fusion (4 cases at L4-L5; 10 cases at L5-S1) and six patients underwent a double level fusion (L4-L5 and L5-S1). Mean operating time was 135 minutes (single level fusion), 175 minutes (double level fusion) and the mean intraoperative blood loss was 177 mL. No perioperative complications were observed and no procedure was converted to open surgical fusion. Patients were allowed to ambulate on the second postoperative day. Fusion was achieved in nineteen patients (fusion rate of 95%) 12 months after surgery.

Conclusions: The BERG technique is a safe, effective, simplified, less technically demanding alternative approach when performing ALIF procedures, without the morbidity associated with laparoscopic or traditional approaches.

References

Correspondence

R. Gazzeri

Via O. Tommasini 13

00162 Roma

Italy

Phone: +39/06/8632 21 37

Fax: +39/06/7705 53 56

Email: robertogazzeri@gmail.com