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Research ArticleLumbar Spine

Lordosis Restoration With Midline Minimally Invasive Cortical Trajectory Screws (MidLF) and Transforaminal Interbody Fusion: A Safe Technique With a Short Stay

Brett Rocos and Ian Harding
International Journal of Spine Surgery May 2021, 8065; DOI: https://doi.org/10.14444/8065
Brett Rocos
Avon Orthopaedic Centre, Brunel Building, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom
MD, FRCS (TR & ORTH)
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Ian Harding
Avon Orthopaedic Centre, Brunel Building, Southmead Hospital, Westbury-on-Trym, Bristol, United Kingdom
BA, FRCS (TR & ORTH)
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ABSTRACT

Background The minimally invasive cortical trajectory screw (MidLF) technique has been described accompanied with posterolateral interbody fusion (PLIF). We present our 2-year results of a hybrid technique to show that using transforaminal interbody fusion (TLIF) rather than PLIF in conjunction with MidLF is a less invasive and safe technique.

Methods We retrospectively identified 25 patients who underwent MidLF with TLIF from July 2015 through September 2017. The surgical technique was the same for each, with radiological, clinical, and patient-reported outcome data collected and analyzed at a 2-year follow-up.

Results The cohort showed a mean age of 55 (35–85) years. The length of hospital stay was between 1 and 4 days, with an average of 2.7 days. Postoperatively, lordosis across the motion segment fused increased by a mean of 7.3° (0°–24°), mean pelvic incidence was 53°(31°–80°), and pelvic tilt reduced by an average of 3.5° (0°–11°). The Oswestry Disability Index improved from 34 preoperatively to 19 postoperatively. Visual analogue pain score–leg improved by 4.7 points, from 6 down to 1. One patient showed delayed wound healing. There were no incidences of neurological injury or durotomy.

Conclusions Our data suggests that MidLF with TLIF is both less invasive than traditional techniques and safe. It restores lordosis, requires less exposure and retraction of neural elements than the more widely used PLIF, and shows early discharge and satisfactory medium-term patient-reported outcomes.

Level of Evidence 3.

Clinical Relevance The MIDLF technique with PLIF is less invasive than traditional techniques, restores alignment and shows satisfactory medium term results.

  • spine fusion
  • spine degeneration
  • spine deformity

Footnotes

  • Disclosures and COI: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The second author, Ian Harding, receives consultation fees from Medtronic Inc.

  • This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Lordosis Restoration With Midline Minimally Invasive Cortical Trajectory Screws (MidLF) and Transforaminal Interbody Fusion: A Safe Technique With a Short Stay
Brett Rocos, Ian Harding
International Journal of Spine Surgery May 2021, 8065; DOI: 10.14444/8065

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Lordosis Restoration With Midline Minimally Invasive Cortical Trajectory Screws (MidLF) and Transforaminal Interbody Fusion: A Safe Technique With a Short Stay
Brett Rocos, Ian Harding
International Journal of Spine Surgery May 2021, 8065; DOI: 10.14444/8065
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