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Minimally Invasive Transforaminal Lumbar Interbody Fusion

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Minimally Invasive Surgery in Orthopedics

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Abstract

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.4–12 These results have been supported by the majority of Class I data.13–18 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.

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Authors and Affiliations

  1. Department of Neurological Surgery, Northwestern Memorial Hospital, Chicago, IL, USA

    Alfred T. Ogden & Richard G. Fessler

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  1. Alfred T. Ogden
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  2. Richard G. Fessler
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Editors and Affiliations

  1. Insall Scott Kelly Institute, East 64th St. 210, New York, 10021, U.S.A.

    Giles R. Scuderi

  2. Orthopaedic Center of New Jersey, Route 27 1527, Somerset, 08873, U.S.A.

    Alfred J. Tria

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Ogden, A.T., Fessler, R.G. (2010). Minimally Invasive Transforaminal Lumbar Interbody Fusion. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76608-9_69

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  • DOI: https://doi.org/10.1007/978-0-387-76608-9_69

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