Gasless endoscopic anterior lumbar interbody fusion utilizing the B. E.R.G. approach.
BACKGROUND
Several authors have reported success using a gas-mediated transperitoneal approach for lumbar interbody fusion. However, this approach has not been shown to reliably and predictably address segments above L4-5.


METHODS
The B.E.R.G. approach was attempted in 202 patients who required anterior lumbar interbody fusion (ALIF). Of those, 168 were completed successfully without conversion to an open procedure. The anterior retroperitoneal approach required no gas insufflation. The gasless environment allowed for the use of standard anterior instrumentation and a variety of fusion grafts and devices.


RESULTS
Mean hospital stay was 1.95 days, with 73% of patients discharged in <47 h following surgery. Clinical results from the first 50 patients, with a minimum 2-year follow-up, include a 92% fusion rate and 78% of patients reporting significant pain relief of greater than 50%.


CONCLUSIONS
The B.E.R.G. approach offers significant technical advantages over the standard gas-mediated transperitoneal approach for ALIF. The clinical results are similar to those reported for open approaches and the gas-mediated transperitoneal approach.
Thalgott
J S
JS
International Spinal Development & Research Foundation, 600 South Rancho Drive, Suite 101, Las Vegas, NV 89106, USA.
Chin
A K
AK
Ameriks
J A
JA
Jordan
F T
FT
Daubs
M D
MD
Giuffre
J M
JM
Fritts
K
K
Timlin
M
M
D000328:Adult; D000368:Aged; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005740:Gases; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery; D011028:Pneumoperitoneum, Artificial; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
D005740:Gases