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Minimally Invasive Transforaminal Lumbar Interbody Fusion

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Abstract

The minimally invasive transforaminal lumbar interbody fusion approach is a versatile technique for the surgical treatment of a multitude of degenerative spinal maladies. It represents a robust and durable approach that provides three-column stability and relief of patients’ pain symptoms. The TLIF technique involves a complete facetectomy and thereby allows for a more lateral exposure to the disk space obviating neural retraction. This chapter describes indications and contraindications for the MIS TLIF approach. We describe a detailed technique to successfully accomplish restoration of lordotic curvature. In order to enhance patient clinical outcomes, pearls and pitfalls described with the approach are addressed. Also, possible surgical complications are herein described and specific ways to avoid these errors are reported. Lastly, a review of the most current literature related to the MIS TLIF approach provides examples of advantages, feasibility, and applications of the technique.

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References

  1. Kim CW, et al. The current state of minimally invasive spine surgery. Instr Course Lect. 2011;60:353–70.

    PubMed  Google Scholar 

  2. Fessler RG. Minimally invasive spine surgery. Neurosurgery. 2002;51(5):S2-iii–iv.

    Google Scholar 

  3. Knight RQ. Minimally invasive spine surgery. Curr Orthop Pract. 2009;20(3):227–31. doi:10.1097/BCO.0b013e31819fd37b.

    Article  Google Scholar 

  4. McAfee PC, et al. Minimally invasive spine surgery. Spine. 2010;35(26S):S271–3. doi:10.1097/BRS.0b013e31820250a2.

    Article  PubMed  Google Scholar 

  5. Allen RT, Garfin SR. The economics of minimally invasive spine surgery: the value perspective. Spine. 2010;35(26S):S375–82. doi:10.1097/BRS.0b013e31820238d9.

    Article  PubMed  Google Scholar 

  6. Ozgur B, Benzel EC, Garfin SR. Minimally invasive spine surgery: a practical guide to anatomy and techniques. Dordrecht: Springer; 2009. p. xvii, 187.

    Book  Google Scholar 

  7. Park P, Foley KT. Minimally invasive transforaminal lumbar interbody fusion with reduction of spondylolisthesis: technique and outcomes after a minimum of 2 years’ follow-up. Neurosurg Focus. 2008;25(2):E16.

    Article  PubMed  Google Scholar 

  8. Figueiredo N, et al. TLIF—transforaminal lumbar interbody fusion. Arq Neuropsiquiatr. 2004;62(3B):815–20.

    Article  PubMed  Google Scholar 

  9. Hackenberg L, et al. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results. Eur Spine J. 2005;14(6):551–8.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Harris BM, et al. Transforaminal lumbar interbody fusion: the effect of various instrumentation techniques on the flexibility of the lumbar spine. Spine. 2004;29(4):E65–70.

    Article  PubMed  Google Scholar 

  11. Baaj AA. Handbook of spine surgery. New York: Thieme; 2012. p. xxiii, 455.

    Google Scholar 

  12. Singh K, Vaccaro AR. Treatment of lumbar instability: transforaminal lumbar interbody fusion. Semin Spine Surg. 2005;17(4):259–66.

    Article  Google Scholar 

  13. Vaccaro AR, Bono CM. Minimally invasive spine surgery. Minimally invasive procedures in orthopedic surgery. New York: Informa Healthcare; 2007. p. xvi, 402.

    Google Scholar 

  14. Chaudhary KS, Groff MW. Minimally invasive transforaminal lumbar interbody fusion for degenerative spine. Tech Orthop. 2011;26(3):146–55. doi:10.1097/BTO.0b013e31822ce25d.

    Article  Google Scholar 

  15. Hoh DJ, Wang MY, Ritland SL. Anatomic features of the paramedian muscle-splitting approaches to the lumbar spine. Neurosurgery. 2010;66(3):ons13–25. doi:10.1227/01.NEU.0000350866.25760.33.

    Article  Google Scholar 

  16. Lehman Jr RA, et al. Standard and minimally invasive approaches to the spine. Orthop Clin North Am. 2005;36(3):281–92.

    Article  PubMed  Google Scholar 

  17. Peng CWBMD, et al. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. Spine. 2009;34(13):1385–9.

    Article  PubMed  Google Scholar 

  18. Wang JC, American Academy of Orthopaedic Surgeons, North American Spine Society. Advanced reconstruction: spine. Rosemont: American Academy of Orthopaedic Surgeons; 2011. p. xxiii, 688.

    Google Scholar 

  19. Gonzalez AA, et al. Intraoperative neurophysiological monitoring during spine surgery: a review. Neurosurg Focus. 2009;27(4):E6.

    Article  PubMed  Google Scholar 

  20. Wiesel SW. Operative techniques in orthopaedic surgery. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.

    Google Scholar 

  21. Neal CJ, Rosner MK. Resident learning curve for minimal-access transforaminal lumbar interbody fusion in a military training program. Neurosurg Focus. 2010;28(5):E21.

    Article  PubMed  Google Scholar 

  22. Lau D, et al. Complications and perioperative factors associated with learning the technique of minimally invasive transforaminal lumbar interbody fusion (TLIF). J Clin Neurosci. 2011;18(5):624–7.

    Article  PubMed  Google Scholar 

  23. Hey HW, Hee HT. Lumbar degenerative spinal deformity: surgical options of PLIF, TLIF and MI-TLIF. Indian J Orthop. 2010;44(2):159–62.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Blondel B, et al. Minimally invasive transforaminal lumbar interbody fusion through a unilateral approach and percutaneous osteosynthesis. Orthop Traumatol Surg Res. 2011;97(6):595–601.

    Article  CAS  PubMed  Google Scholar 

  25. Bindal RK, et al. Surgeon and patient radiation exposure in minimally invasive transforaminal lumbar interbody fusion. J Neurosurg Spine. 2008;9(6):570–3.

    Article  PubMed  Google Scholar 

  26. Chen N-F, et al. Symptomatic ectopic bone formation after off-label use of recombinant human bone morphogenetic protein-2 in transforaminal lumbar interbody fusion. J Neurosurg Spine. 2010;12(1):40–6.

    Article  PubMed  Google Scholar 

  27. Knox CJB, Dai CJMI, Orchowski LJ. Osteolysis in transforaminal lumbar interbody fusion with bone morphogenetic protein-2. Spine. 2011;36(8):672–6. doi:10.1097/BRS.0b013e3181e030e0.

    Article  PubMed  Google Scholar 

  28. Rihn JA, et al. The use of RhBMP-2 in single-level transforaminal lumbar interbody fusion: a clinical and radiographic analysis. Eur Spine J. 2009;18(11):1629–36.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Glassman SD, et al. Complications and concerns with osteobiologics for spine fusion in clinical practice. Spine. 2010;35(17):1621–8. doi:10.1097/BRS.0b013e3181ce11cc.

    Article  PubMed  Google Scholar 

  30. Karikari IO, Isaacs RE. Minimally invasive transforaminal lumbar interbody fusion: a review of techniques and outcomes. Spine. 2010;35(26S):S294–301. doi:10.1097/BRS.0b013e3182022ddc.

    Article  PubMed  Google Scholar 

  31. Lee CK, Park JY, Zhang HY. Minimally invasive transforaminal lumbar interbody fusion using a single interbody cage and a tubular retraction system: technical tips, and perioperative, radiologic and clinical outcomes. J Korean Neurosurg Soc. 2010;48(3):219–24.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Wu RHBS, Fraser JFMD, Hartl RMD. Minimal access versus open transforaminal lumbar interbody fusion: meta-analysis of fusion rates. Spine. 2010;35(26):2273–81.

    Article  PubMed  Google Scholar 

  33. Parker SL, et al. Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg. 2011;54(01):33,37.

    Article  Google Scholar 

  34. Adogwa O, et al. Comparative effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion: 2-year assessment of narcotic use, return to work, disability, and quality of life. J Spinal Disord Tech. 2011;24(8):479–84. doi:10.1097/BSD.0b013e3182055cac.

    PubMed  Google Scholar 

  35. Parker SL, et al. Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years. World Neurosurg. 2012;78:178–84.

    Article  PubMed  Google Scholar 

  36. Rouben D, Casnellie M, Ferguson M. Long-term durability of minimal invasive posterior transforaminal lumbar interbody fusion: a clinical and radiographic follow-up. J Spinal Disord Tech. 2011;24(5):288–96. doi:10.1097/BSD.0b013e3181f9a60a.

    Article  PubMed  Google Scholar 

  37. Wang J, et al. Minimally invasive or open transforaminal lumbar interbody fusion as revision surgery for patients previously treated by open discectomy and decompression of the lumbar spine. Eur Spine J. 2011;20(4):623–8.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Beringer WF, Mobasser J-P. Unilateral pedicle screw instrumentation for minimally invasive transforaminal lumbar interbody fusion. Neurosurg Focus. 2006;20(3):1–5.

    Google Scholar 

  39. Holly LT, et al. Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications. Neurosurg Focus. 2006;20(3):1–5.

    Article  Google Scholar 

  40. Deutsch H, Musacchio MJ. Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation. Neurosurg Focus. 2006;20(3):1–5.

    Article  Google Scholar 

  41. Tuttle J, Shakir A, Choudhri HF. Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation. Neurosurg Focus. 2006;20(3):1–5.

    Article  Google Scholar 

  42. Rosen DS, et al. Obesity and self-reported outcome after minimally invasive lumbar spinal fusion surgery. Neurosurgery. 2008;63(5):956–60. doi:10.1227/01.NEU.0000313626.23194.3F.

    Article  PubMed  Google Scholar 

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Correspondence to Kern Singh MD .

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Pelton, M.A., Nandyala, S.V., Marquez-Lara, A., Singh, K. (2014). Minimally Invasive Transforaminal Lumbar Interbody Fusion. In: Phillips, F., Lieberman, I., Polly, D. (eds) Minimally Invasive Spine Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5674-2_16

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  • DOI: https://doi.org/10.1007/978-1-4614-5674-2_16

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