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Research ArticleMinimally Invasive Surgery

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

Daivik B. Vyas, Brian J. Park and Michael Y. Wang
International Journal of Spine Surgery February 2025, 19 (S1) S28-S36; DOI: https://doi.org/10.14444/8713
Daivik B. Vyas
1 Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA
MD
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Brian J. Park
1 Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA
MD
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Michael Y. Wang
1 Department of Neurosurgery, Miller School of Medicine, University of Miami, Miami, FL, USA
MD
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  • For correspondence: MWang2@med.miami.edu
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    Figure 1

    Example of tubular minimally invasive surgery transforaminal lumbar interbody fusion performed on right side. Case demonstrates a tubular system with integrated 22.5° camera for visualization. Image orientation: top, medial; bottom, lateral; left, caudal; and right, cranial. (A) Facet joint complex visualization after initial soft tissue dissection. (B) Facetectomy, hemilaminotomy, and exposure of ligamentum flavum. (C) Lateral edge of thecal sac and traversing nerve root visualized after resection of ligament.

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    Figure 2

    Example of tubular minimally invasive surgery transforaminal lumbar interbody fusion performed on the right side. Disc-space preparation and interbody placement. Image orientation: top, medial; bottom, lateral; left, caudal; and right, cranial. (A) Prediscectomy visualization of transforaminal corridor. (B) Protection of the traversing nerve root with a self-retaining protector. (C) Annulotomy. (D) Initial dilator placement. (E) Tube rotation 90° clockwise and shaver introduction. (F) Disc space preparation. (G) Placement of bone morphogenetic protein. (H) Implant placement. (I) Retractor removal and final view.

  • Figure 3
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    Figure 3

    Example of endoscopic minimally invasive surgery transforaminal lumbar interbody fusion. (A) Anteroposterior and (B) lateral fluoroscopy for localization. (C) Disc space preparation through the final working channel. (D) Endoscopic view of disc space (left, bottom), traversing nerve root (right, top). (E) Endplate preparation. (F) Anteroposterior and (G) lateral fluoroscopic views of the final construct. Figure adapted with permission.15,18

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International Journal of Spine Surgery: 19 (S1)
International Journal of Spine Surgery
Vol. 19, Issue S1
1 Feb 2025
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Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review
Daivik B. Vyas, Brian J. Park, Michael Y. Wang
International Journal of Spine Surgery Feb 2025, 19 (S1) S28-S36; DOI: 10.14444/8713

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Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review
Daivik B. Vyas, Brian J. Park, Michael Y. Wang
International Journal of Spine Surgery Feb 2025, 19 (S1) S28-S36; DOI: 10.14444/8713
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  • Article
    • Abstract
    • Introduction
    • The Tubular TLIF Technique
    • The Endoscopic TLIF Technique
    • Enabling Technologies
    • Anesthesia Considerations
    • Outcomes of MIS-TLIF Approaches
    • Conclusion
    • Acknowledgments
    • Footnotes
    • References
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More in this TOC Section

  • Comparative Review of Lateral and Oblique Lumbar Interbody Fusion: Technique, Outcomes, and Complications
  • A Spine Surgeon’s Learning Curve With the Minimally Invasive L5 to S1 Lateral ALIF Surgical Approach: Perioperative Outcomes and Technical Considerations
  • Fully Navigated Single-Position Prone Lateral Lumbar Interbody Fusion: A Detailed Technical Report and Description of 15 Cases
Show more Minimally Invasive Surgery

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Keywords

  • MIS (minimally invasive surgery)
  • TLIF (transforaminal lumbar interbody fusion)
  • endoscopy

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