The advent of minimally invasive surgery has provided surgeons new techniques for treating clinical disease. Within the field of spinal surgery, techniques in lumbar interbody arthrodesis have shown a continued evolution of procedural approach and instrumentation. Minimally invasive spine surgery aims to reduce approach related morbidity, while producing clinical outcomes comparable to its open predecessors. One important example of this is the development of minimally invasive techniques for lumbar interbody fusion, including transforaminal lumbar interbody fusion (TLIF). We have had many patients throughout the Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville, Duncanville and throughout the DFW metroplex experience very positive outcomes with the procedure.

The MI-TLIF technique, has displayed comparable outcomes to open TLIF, while adding the benefits of less approach-related morbidity, decreased intraoperative blood loss, and shorter hospital stays. However, critics of the technique have noted that the MI-TLIF has longer operative times and exposes patients to increased fluoroscopic radiation. Over the past decade MI-TLIF has been shown to have a number of benefits, especially with regard to peri-operative outcomes. However, it may have its own unique challenges and potential morbidity. Ultimately, comparing the known literature of a traditional, open TLIF approach to published reports on MI-TLIF will identify the unique risks and benefits associated with each. This understanding may help guide improved clinical decision making for patients presenting with spondylolisthesis, lumbar instability, or lumbar degenerative disk disease.

The operative surgeon additionally must be familiar with 3D lumbar anatomy and be able to carefully interpret 2D radiographic images to make a mental reconstruction. This is a unique skill and one that is not as critical with a traditional, open approach. The surgeon must be able to read anterior-posterior and lateral imaging in order to accurately insert percutaneous pedicle screws, thereby allowing for possible misinterpretation leading to complications. Screw misplacement and cage migration or subsidence accounted for 44.8% of complications reported in MI-TLIF comparative studies.

Once the procedure is mastered, its application can positively impact patient care in numerous ways. But, the fundamental advantage of MI-TLIF comes from its decrease in tissue trauma and overall exposure of the patient. test

Schedule an Appointment