scholarly journals Two-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: Surgical Technique and Illustrative Cases

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Rory J. Petteys ◽  
Jay Rhee ◽  
Jean-Marc Voyadzis
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Wound Complications ◽  
Foraminal Stenosis ◽  
Lumbar Interbody Fusion ◽  
Review Of The Literature ◽  
Disc Disease ◽  
Common Procedure ◽  
Invasive Techniques

Transforaminal lumbar interbody fusion (TLIF) is a common procedure performed by spine surgeons. The indications for TLIF include back pain and radiculopathy as a consequence of canal or foraminal stenosis, degenerative disc disease, spondylolisthesis, or deformity. Minimally invasive techniques (MIS) have proven to be effective for single-level TLIF and are associated with less blood loss, fewer wound complications and infections, faster recovery, and decreased hospital cost. To date, there is very little data on 2-level MIS TLIF. We present our technique for 2-level MIS TLIF with case illustrations and a review of the literature.

Minimally invasive tubular surgery for transforaminal lumbar interbody fusion

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video19 ◽  
Author(s):  
Jon Kimball ◽  
Andrew Yew ◽  
Ruth Getachew ◽  
Daniel C. Lu
Keyword(s):  
Minimally Invasive ◽  
Posterior Approach ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Postoperative Patient ◽  
Common Procedure ◽  
Circumferential Fusion ◽  
Single Posterior Approach ◽  
Invasive Techniques

Transforaminal lumbar interbody fusion (TLIF) was originally developed as a method for circumferential fusion via a single posterior approach and is now an extremely common procedure for the treatment of lumbar instability. More recently, minimally invasive techniques have been applied to this procedure with the goal of decreasing tissue disruption, blood loss and postoperative patient discomfort. Here we describe a minimally invasive tubular TLIF on a 60-year-old male with radiculopathy from an unstable L4–5 spondylolisthesis.The video can be found here: http://youtu.be/0BbxQiUmtRc.

scholarly journals Comparison of complication rates of minimally invasive transforaminal lumbar interbody fusion and lateral lumbar interbody fusion: a systematic review of the literature

2015 ◽  
Vol 39 (4) ◽  
pp. E4 ◽  
Author(s):  
Jacob R. Joseph ◽  
Brandon W. Smith ◽  
Frank La Marca ◽  
Paul Park
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Neurological Deficit ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Deficits ◽  
Wound Complications ◽  
Medical Complications ◽  
Lumbar Interbody Fusion ◽  
Sensory Deficits

OBJECT Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and lateral lumbar interbody fusion (LLIF) are 2 currently popular techniques for lumbar arthrodesis. The authors compare the total risk of each procedure, along with other important complication outcomes. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies (up to May 2015) that reported complications of either MI-TLIF or LLIF were identified from a search in the PubMed database. The primary outcome was overall risk of complication per patient. Secondary outcomes included risks of sensory deficits, temporary neurological deficit, permanent neurological deficit, intraoperative complications, medical complications, wound complications, hardware failure, subsidence, and reoperation. RESULTS Fifty-four studies were included for analysis of MI-TLIF, and 42 studies were included for analysis of LLIF. Overall, there were 9714 patients (5454 in the MI-TLIF group and 4260 in the LLIF group) with 13,230 levels fused (6040 in the MI-TLIF group and 7190 in the LLIF group). A total of 1045 complications in the MI-TLIF group and 1339 complications in the LLIF group were reported. The total complication rate per patient was 19.2% in the MI-TLIF group and 31.4% in the LLIF group (p < 0.0001). The rate of sensory deficits and temporary neurological deficits, and permanent neurological deficits was 20.16%, 2.22%, and 1.01% for MI-TLIF versus 27.08%, 9.40%, and 2.46% for LLIF, respectively (p < 0.0001, p < 0.0001, p = 0.002, respectively). Rates of intraoperative and wound complications were 3.57% and 1.63% for MI-TLIF compared with 1.93% and 0.80% for LLIF, respectively (p = 0.0003 and p = 0.034, respectively). No significant differences were noted for medical complications or reoperation. CONCLUSIONS While there was a higher overall complication rate with LLIF, MI-TLIF and LLIF both have acceptable complication profiles. LLIF had higher rates of sensory as well as temporary and permanent neurological symptoms, although rates of intraoperative and wound complications were less than MI-TLIF. Larger, prospective comparative studies are needed to confirm these findings as the current literature is of relative poor quality.

scholarly journals COMPLICATIONS IN THREE LUMBAR ARTHRODESIS TECHNIQUES: TLIF, MITLIF, PLIF

2017 ◽  
Vol 16 (1) ◽  
pp. 74-77 ◽  
Author(s):  
AVELINO AGUILAR MERLO ◽  
RICARDO ROJAS BECERRIL ◽  
MARIO LORETO LUCAS ◽  
SHEILA PATRICIA VÁZQUEZ ARTEAGA
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Posterior Lumbar Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Spine Surgeon ◽  
Lumbar Spondylolisthesis ◽  
Incidental Durotomy ◽  
Invasive Techniques

ABSTRACT Objective: To determine that minimally invasive transforaminal lumbar fusion has fewer complications of chronic lumbar instability compared with traditional open techniques. Methods: Retrospective, observational study of 132 patients with grade I and II lumbar spondylolisthesis with advanced disc degeneration. Forty-five patients operated by minimally invasive transforaminal lumbar interbody fusion (MITLIF), 45 patients operated by posterior lumbar interbody fusion (PLIF) and 42 patients operated by open transforaminal lumbar interbody fusion (TLIF). Results: Four patients had incidental durotomy, two in the TLIF group and two in the PLIF group. There were no cases of incidental durotomy in the minimally invasive transforaminal access group. No patient in the study presented an inadequate screw position, the lowest mean bleeding occurred in the group of minimally invasive instrumentation of one and two levels. There were 6.6% of infections for PLIF group and none in the other two groups. Conclusions: Arthrodesis techniques are not free of complications, however, the frequency is lower with minimally invasive techniques. Nonetheless, it requires training and does not dispense the need for a learning curve for the spine surgeon compared to open lumbar fusion techniques.

scholarly journals Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications

2006 ◽  
Vol 20 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Langston T. Holly ◽  
James D. Schwender ◽  
David P. Rouben ◽  
Kevin T. Foley
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Radicular Pain ◽  
Low Back ◽  
Lumbar Interbody Fusion ◽  
Disc Disease ◽  
Dorsal Approach ◽  
Tubular Retractor

✓The authors provide an overview of the minimally invasive transforaminal lumbar interbody fusion (TLIF) procedure including indications, technique, and complications. This novel technique is a method of achieving circumferential lumbar fusion using a unilateral dorsal approach. Minimally invasive TLIF uses a tubular retractor that is inserted via a muscle-dilating exposure, thereby minimizing the approach-related morbidity. This procedure is ideal for refractory mechanical low-back and radicular pain associated with spondylolisthesis, degenerative disc disease, and recurrent disc herniation. The authors' clinical experience and review of the medical literature indicate that TLIF can be effectively and safely performed in a minimally invasive fashion.

Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation

2006 ◽  
Vol 20 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Jonathan Tuttle ◽  
Ahmed Shakir ◽  
Haroon Fiaz Choudhri
Keyword(s):  
Minimally Invasive ◽  
Patient Population ◽  
Interbody Fusion ◽  
Lumbar Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Minimally Invasive Techniques ◽  
Previous Surgery ◽  
Unilateral Pedicle Screw ◽  
Invasive Techniques

✓ Lumbar fusion is a commonly performed procedure for a variety of pathological conditions, and it is frequently used in the treatment of degenerative lumbar instability that is refractory to medical management. Pedicle screws and interbody devices have been used for internal fixation to promote arthrodesis, prevent nonunion, and facilitate early mobilization. Recently, attempts have been made to reduce the morbidity associated with lumbar fusion by using a variety of minimally invasive techniques. Many minimally invasive lumbar fusion procedures require specialized retractors, implants, image guidance systems, or insertion instruments. Other minimally invasive techniques are primarily applied to an ideal patient population (thin, healthy, and with no previous surgery). The authors describe their experience with a paramedian approach for minimally invasive transforaminal lumbar interbody fusion (TLIF) with unilateral pedicle screw (PS) fixation. This procedure requires only standard implants, instruments, and retractors, with direct visualization for all aspects of the procedure. The authors describe encouraging early results in a challenging patient population in which there was a high incidence of obesity, medical comorbidities, and previous surgery at the same level. The paramedian approach for TLIF performed using unilateral lumbar PSs has yielded successful outcomes in this series of 47 patients, and further study of this technique may help define its role as a minimally invasive procedure for spinal fusion.

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