To discuss the effect of treatment and the matters needing attention during the operation Through percutaneous transforaminal endoscopic surgery for Adjacent segmental disease after lumbar fusion.

From January 2015 to August 2016, 34 elderly patients (25 males and 9 females) with adjacent vertebral diseases occurred after lumbar fusion. The age ranged from 61 to 81 years, with an average of (66±7) years. All patients underwent percutaneous endoscopic decompression via transforaminal approach. Record the time of operation and the matters needing attention during the operation. In the preoperative and postoperative 1, 6, 12 months and the last follow-up, the clinical efficacy was evaluated according to the MacNab standard, the visual analogue score of the pain of the waist and lower limbs (VAS) and the Oswestry dysfunction index (ODI) were performed. During the follow-up of 6 months, lumbar MRI was performed to evaluate the status of nerve root decompression, and the stability of the operation was evaluated by anteroposterior and lateral lumbar radiographs and dynamic radiographs.

The operation time was successfully completed in all 34 patients. The time of operation was 54-142 min, with an average of (68±30) min. The follow-up time was 24-44 months, with an average of (32±7) months. The scores of ODI at 1, 6, 12 months and final follow-up were significantly lower than those before operation (F=2008.780, P<0.001); The scores of Low back pain VAS at 1, 6, 12 months and final follow-up were significantly lower than those before operation (F=599.821, P<0.001); The scores of Lower limb pain VAS at 1, 6,12 months and final follow-up were significantly lower than those before operation (F=601.751, P<0.001). At the time of follow up in June, the modified MacNab criteria assessed excellent outcomes in 27 cases, good in 5 cases, and fair in 2 cases, with an excellent and good rate of 94.12%.One case had rupture of the guide wire, one case had tear of the epineurium of the outlet nerve root, and one case had irritation of the outlet root. At the last follow-up, 3 cases of intervertebral instability were found. No nerve root and dural sac injury occurred, no operative segment errors occurred.

Percutaneous intervertebral foramen endoscopic treatment of adjacent vertebral disease in elderly patients after lumbar fusion has less trauma and good clinical effect.