Minimally invasive transforaminal lumbar interbody fusion
Minimally invasive transforaminal lumbar interbody fusion was first described in the literature by Foley et al 1) in 2003, has become popular since its introduction because of concerns that open TLIF may result in significant soft tissue injury 2) 3)
MIS-TLIF is associated with radiologic decompression of lumbar foraminal stenosis and central spinal canal stenosis. The mechanism for neural foraminal and central canal decompression is likely driven by a combination of direct and indirect corrective techniques 4).
MIS TLIF and conventional TLIF showed similar clinical and radiological outcomes. MIS TLIF may be a better choice for two- or three-segment lumbar fusion in perioperative outcomes 5).
The medial-lateral expandable TLIF cage (MLX-TLIF) with unilateral pedicle screw fixation provided comparable stability to conventional TLIF with bilateral PS fixation and ALIF with anterior plate treatments. The large footprint of the expandable cage may reduce the TLIF supplemental fixation demands and facilitate minimally invasive single-position surgery. If needed, additional stability may be achieved by using bilateral PS 6).
Outcome
Minimally invasive transforaminal lumbar interbody fusion (MITLIF or MIS-TLIF…) is a well-described procedure with excellent reported outcomes. A modification of interbody graft placement can potentially improve the ease and safety of this procedure.
Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a common surgical option for degenerative spondylolisthesis (DS), with similar clinical outcomes when used to treat both isthmic spondylolisthesis and degenerative spondylolisthesis. Although disc height restoration was more effective for IS than DS, other radiologic parameters including fusion rate were no different between groups. For both isthmic and degenerative spondylolisthesis, MIS TLIF can be a safe and effective surgical option 7).
Videos
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