Abstract

Fusion or not fusion is still controversy in the spine surgery subjects. PLIF declared that it should replace simple discectomy, 360^◦ fusion and successfully be performed in Lumbar spine surgery. Spine surgery is going to more less and minimal invasive procedures. Less invasive procedures are including fusion as well as traditional method. Minimal invasive surgery is gradually most popular method every now. Percutaneous endoscopic procedures trend to refuse fusion and to protect segmental stability with distraction devices like nucleus prosthesis and interspinous devices. Most recently B-twin expandable cage could be performed during the transforaminal surgery. However clinical outcome does not appear to give superior results to other methods. Fusion rate is not reported. It works like distraction devices for foraminal stenosis and show an improvement in the overall pain and disability. Percutaneous endoscopic fusion is possible after to develop more aggressive motorized and manual tools and devices to assite 360^◦ fusion. It is strongly possible percutaneous transforaminal endoscopic fusion safe and reliable method with advantages that include reduced operating time, blood loss, post-operative analgesia requirements and hospitalization.