P50. Disc Space Preparation in Transforaminal Interbody Fusion: A Comparison of Open and Minimally Invasive Technique

2006 ◽  
Vol 6 (5) ◽  
pp. 108S
Author(s):  
Peter Grossi ◽  
Louis Radden ◽  
Pradhan Ashtoush ◽  
Isaacs Robert
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Disc Space ◽  
Transforaminal Interbody Fusion

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Motohide Shibayama ◽  
Guang Hua Li ◽  
Li Guo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

scholarly journals MICROSURGICAL LANDMARKS IN MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION

2015 ◽  
Vol 14 (4) ◽  
pp. 317-319 ◽  
Author(s):  
Javier Quillo-Olvera ◽  
Sergio Soriano-Solis ◽  
Ramses Uriel Ortiz-Leyva ◽  
Carlos Francisco Gutiérrez-Partida ◽  
Manuel Rodríguez-García ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Lumbar Interbody Fusion ◽  
Anatomical Models ◽  
Tubular Retractor ◽  
Surgical Field

Microsurgical landmarks of the facet joint complex were defined to provide guidance and security within the tubular retractor during transforaminal surgery. A retrospective observational study was performed in segments L4-L5 by the left side approach. Microsurgical relevant photos, anatomical models and drawing were used to expose the suggested landmarks. The MI-TLIF technique has advantages compared with conventional open TLIF technique, however minimally invasive technique implies lack of security for the surgeon due to the lack of defined microanatomical landmarks compared to open spine surgery, and disorientation within the tubular retractor, the reason why to have precise microsurgical references and its recognition within the surgical field provide speed and safety when performing minimally invasive technique.

A novel minimally invasive technique for lumbar decompression, realignment, and navigated interbody fusion

2015 ◽  
Vol 22 (9) ◽  
pp. 1484-1490 ◽  
Author(s):  
Clemens Reinshagen ◽  
Daniel Ruess ◽  
Brian P. Walcott ◽  
Marek Molcanyi ◽  
Roland Goldbrunner ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Interbody Fusion ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Lumbar Decompression

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Author(s):  
Motohide Shibayama ◽  
GuangHua Li ◽  
LiGuo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background: Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results.Methods: Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results: Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery.Conclusions: mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

scholarly journals The Mini-Open transpedicular thoracic discectomy: surgical technique and assessment

2008 ◽  
Vol 25 (2) ◽  
pp. E5 ◽  
Author(s):  
John H. Chi ◽  
Sanjay S. Dhall ◽  
Adam S. Kanter ◽  
Praveen V. Mummaneni
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Disc Space ◽  
Disc Herniations ◽  
Thoracic Disc ◽  
Mini Open

Object Thoracic disc herniations can be surgically treated with a number of different techniques and approaches. However, surgical outcomes comparing the various techniques are rarely reported in the literature. The authors describe a minimally invasive technique to approach thoracic disc herniations via a transpedicular route with the use of tubular retractors and microscope visualization. This technique provides a safe method to identify the thoracic disc space and perform a decompression with minimal paraspinal soft tissue disruption. The authors compare the results of this approach with clinical results after open transpedicular discectomy. Methods The authors performed a retrospective cohort study comparing results in 11 patients with symptomatic thoracic disc herniations treated with either open posterolateral (4 patients) or mini-open transpedicular discectomy (7 patients). Hospital stay, blood loss, modified Prolo score, and Frankel score were used as outcome variables. Results Patients who underwent mini-open transpedicular discectomy had less blood loss and showed greater improvement in modified Prolo scores (p = 0.024 and p = 0.05, respectively) than those who underwent open transpedicular discectomy at the time of early follow-up within 1 year of surgery. However, at an average of 18 months of follow-up, the Prolo score difference between the 2 surgical groups was not statistically significant. There were no major or minor surgical complications in the patients who received the minimally invasive technique. Conclusions The mini-open transpedicular discectomy for thoracic disc herniations results in better modified Prolo scores at early postoperative intervals and less blood loss during surgery than open posterolateral discectomy. The authors' technique is described in detail and an intraoperative video is provided.

scholarly journals Microendoscopy-assisted Extraforaminal Lumbar Interbody Fusion for Treating Single-level Spondylodesis

2020 ◽  
Author(s):  
Motohide Shibayama ◽  
GuangHua Li ◽  
LiGuo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background: Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results.Methods: Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results: Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery.Conclusions: mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

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