Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review.

Abstract

Background: Transforaminal lumbar interbody fusion (TLIF) achieves anterior and posterior spinal arthrodesis through a single approach. Minimally invasive surgery (MIS) methods reduce surgical morbidity while achieving positive outcomes.

Methods: The major MIS-TLIF techniques, from tubular to endoscopic approaches, are reviewed with a discussion on the incorporation of new technologies and a comparative review of their outcomes.

Results: MIS-TLIF approaches span a spectrum of visualization methods, with technical nuances related to patient and surgeon-specific factors determining optimal fit. To date, the superiority of 1 technique has yet to be definitively determined. Existing techniques may be integrated in a personalized manner to optimize surgical utility.

Conclusions: Selection of an MIS-TLIF modality relies on a calculus between patient characteristics and surgeon faculty; proper selection can offer significant benefits to patients with spine disease.

Clinical relevance: Emerging technologies for MIS-TLIF comprise a major source of development and clinical translation, while the safe and effective use of these techniques promises greater patient benefit in the right populations.