Minimally Invasive Transforaminal Lumbar Interbody Fusion

  • Alfred T. Ogden
  • Richard G. Fessler


During the past 75 years, surgical technique, spinal instruments and instrumentation, and molecular biology have advanced the notion of lumbar interbody fusion from what Mercer1 described, in 1936, as perhaps “technically impossible” to a routine operation with a high rate of success. Pedicle screw augmentation of the posterior lateral interbody fusion (PLIF) described by Cloward2 made possible a decompressive operation and arthrodesis with “360°” of stabilization from a single posterior approach. The transforaminal lumbar interbody fusion (TLIF) described by Harms and Rolinger3 in 1982 offered the same biomechanical result as the PLIF but has gained more widespread popularity because it requires less manipulation of neural structures during graft placement. Although both the PLIF and TLIF are viable using minimally invasive techniques, the minimally invasive TLIF (miTLIF) has become the dominant minimally invasive lumbar fusion procedure.

Retrospective surgical series have reported high rates of efficacy for both open PLIF and open TLIF in terms of fusion rates and clinical outcome for a variety of indications.412 These results have been supported by the majority of Class I data.1318 Although debate continues over whether the theoretical advantages of an instrumented 360° fusion have translated into a clinical benefit over noninstrumented fusions or posterior lateral onlay fusions (PLF),19,20 posterior interbody grafting and percutaneous pedicle screw placement has enabled the development of minimally invasive lumbar fusion procedures that would not otherwise be possible.


Pedicle Screw Oswestry Disability Index Interbody Fusion Ligamentum Flavum Lumbar Fusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Alfred T. Ogden
    • 1
  • Richard G. Fessler
    • 1
  1. 1.Department of Neurological SurgeryNorthwestern Memorial HospitalChicagoUSA

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