Minimally invasive transforaminal lumbar interbody fusion

초록

Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is the standard minimally invasive fusion technique based on the tubular retractor to minimize muscle damage. The tubular retractor is used to effectively expose the desired area by promoting inclination with a small incision. A unilateral facet joint is removed through a paramedian incision, and the disc can be accessed through this space to obtain interbody fusion. The desired level of contralateral decompression can be performed by tilting the table, even without contralateral facetectomy. The advantages of MIS-TLIF include not only the cosmetic effect due to the small incision but more importantly, the minimization of injury to paraspinal structures during surgery. Unlike conventional open fusion surgery, which requires extensive periosteal dissection, MIS-TLIF mostly preserves paraspinal muscular structures. Furthermore, MIS-TLIF has been associated with reduced blood loss, shorter operative times, and a low perioperative complication rate. Another merit of MIS-TLIF is that it has a wide indication, as in conventional open fusion surgery, except for the invisible pedicle with fluoroscopy. It is worth noting that a learning curve for MIS-TLIF can be overcome in 20-40 cases. Therefore, this chapter will provide a guide for overcoming this learning curve early. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.

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