Operative Concept
Technical boundaries of endoscopic lumbar fusion
UBE-TLIF has technical and biological limits that should be stated clearly in preoperative planning.
Fusion indication first
The rationale for fusion should be established before focusing on the access method. Instability, foraminal collapse, recurrent stenosis, and expected decompression-related destabilization are common considerations.
Implant and graft constraints
Endplate preparation, cage trajectory, bone quality, disc height, and fixation strength influence whether an endoscopic fusion strategy is technically appropriate.
When to choose another approach
Severe deformity, high-grade slip, major sagittal correction needs, infection, tumor, or inadequate fixation environment may require a different surgical strategy.