It is not meant to replace any personal conversations that you might wish to have with your physician or other member of your healthcare team. Modified miniopen transforaminal lumbar interbody fusion. Attach the arm post to the table rail once the surgical preparation and draping are completed. Abstract the surgical procedures used for arthrodesis in the. Traditional transforaminal lumbar interbody fusion tlif is characterized by great trauma. It is sometimes necessary to give blood transfusions either during or after surgery. In recent years, surgical treatment of lumbar degenerative diseases has shown a minimallyinvasive trend, with the tlif tech nique developing to miniopen incisions. Place the patient in the prone or kneechest position on a radiolucent operating table. Lumbar transforaminal lumbar interbody fusion tlif. The tlif technique is based on creating unilateral access to the intervertebral disc space by entering via an intervertebral foramen. To describe a modified technique for miniopen transforaminal lumbar interbody fusion tlif that improves. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain.
An adaptation of the posterior lumbar interbody fusion plif technique first described by cloward, the t. Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace other than for decompression. Continuously expandable vertebral body replacement for. Transforaminal lumbar interbody fusion motlif surgical. In the typical or setup for a mis tlif, the surgeon stands on the side of the. Transforaminal lumbar interbody fusion tlif which utilizes only endoscopy visualization such as a percutaneous. Phenix, cervical interbody system sales sheet tech sheet surgical technique surgical technique animation instrument guide usage form fda clearance. Alif, a number of technique tips apply in every interbody fusion procedure. A minimally invasive transforaminal lumbar interbody fusion mis tlif has recently been introduced. Before unlocking the trial, confirm by fluoroscopy that. The tlif arose as an improvement of plif, accessesing the. Surgical technique 4 the following technique describes the unilateral insertion of a single implant into the disc space through a posterior lumbar interbody fusion plif approach, transforaminal lumbar interbody fusion tlif approach or anywhere in between based on the pathology being addressed and surgeon preference. Minimally invasive transforaminal lumbar interbody fusion for lumbar spondylolisthesis. Transforaminal lumbar interbody fusion tlif utilizes a more lateral window in.
Mini open tlif through a modified wiltse paraspinal approach. Minimally invasive surgery mis represents one of the most exciting and dynamic segments of spine surgery. Large bone graft windows are located through the body of the device to allow for. This approach is similar to plif, the difference being that only one side of the back is accessed and affected. Please refer to the stryker retractor system surgical technique guides, including luxor, phantom, and. Modified miniopen transforaminal lumbar interbody fusion description of surgical technique and assessment of freehand pedicle screw insertion peyman pakzaban, md study design. The authors performed retrospective analysis about mis tlif using a single interbody cage.
All images in this technique guide depict an open tlif procedure for image clarity. Pdf twolevel minimally invasive transforaminal lumbar. Preparation and access step 1 patient positioning position on radiolucent table with adequate clearance for a fluoroscopic carm for ap lateral and oblique images of pedicle and vertebral body. Extreme lateral interbody fusion xlif is a relatively new tech nique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach.
Unilateral posterior approach using 28mm and 32 mm spacers figure 1 bilateral posterior approach using 24mm spacers 2efigr u. This article has been saved into your user account, in the favorites area, under the new folder. The aim of this study is to provide a comparative analysis of open vs. A tlif procedure can be performed using a standard open or minimally invasive approach. Lumbar interbody fusion is a wellestablished surgical procedure for treating several spinal disorders. Minimally invasive transforaminal lumbar interbody fusion.
Tlif transforaminal lumbar interbody fusion nicandro figueiredo 1, johnny wesley g. Transforaminal lumbar interbody fusion tlif technique. Results clinical outcome was excellent or good in 76% of the patients in whom instrumentation was placed and in 85% of those in whom no instrumentation was placed p 0. Clinical outcomes after minimally invasive transforaminal. A radiolucent or table is recommended, as xray shall be.
It is not intended to represent actual surgical technique or results. First, even when open technique is employed, careful attention to soft tissue handling can help improve posterior rmuscular function and may decrease pain. Lumbar interbody fusion is a surgical technique that attempts to eliminate instability in the back. The tlif implant consists of banana shaped blocks in a parallel configuration of various heights 8mm 16mm, in 2mm increments. Understanding the options for cage placement is important for surgeons considering the use of this technique. Case report single transverseorientation cage via mis. Impacted cages made of titanium, carbonfiber reinforced or plain peek polymer polyetheretheketone. Expandable tlif and plif technology surgical technique. Make sure the abdomen is free positioned to avoid pressure on the large vessels and to minimize blood loss. Although a first detailed description of the tlif technique was given by harms and jeszenszky 14 as early as 1998 the number of published papers concerning its outcome and complications is limited.
In the plif technique, surgical access to the intervertebral disc is gained from a posterior. Mini open transforaminal lumbar interbody fusion motlif is a powerful minimally invasive surgical mis technique that achieves decompression, interbody fusion, posterolateral fusion, pedicle screw instrumentation and lowgrade spondylolisthesis reduction table 1. The nerves of the lumbar plexus reside within the psoas, and the technique. Single transverseorientation cage via mistlif approach can maintain greater lumbar lordosis and avoid the unique complications of lateral transpsoas approach. Thanks to its material properties and its approval certificates, peek is predestined for use as an implant material. Miniopen tlif through a modified wiltse paraspinal approach. Arthrodesis techniques are not free of complications, however, the frequency is lower. Mas tlif is an efficient and reproducible technique that offers the same advantages as traditional tlif, but with the added benefit of less tissue disruption and therefore potentially less postoperative pain and quicker recovery. Pdf l5s1 anterior lumbar interbody fusion technique. Transforaminal lumbar interbody fusion tlif was initially introduced in the early 1980s. The unilateral transforaminal lumbar interbody fusion tlif represents an alternative surgical technique avoiding both the anterior approach and the approach through the spinal canal. Lastly, scraping the endplates clean of cartilage completes the disc preparation. Also there is no problem for insertion of usual size of tlif cages using a 22 mm diameter rigid tube.
Mitlif techniques can be used to effectively reduce spondylolisthesis, increase. Insight tube has the additional advantage of the leyla type mobile. Odi decreased the literature documents improvement in functional 29. Surgical interbody fusion of degenerative levels is an effective treatment option to stabilize the. Eit tlif cage surgical technique preparation and approach the patient is placed on the or table using the standard positioning in cases of transforaminal lumbar interbody fusion. Care should be taken to ensure the interbody spacer is aligned properly. Surgical technique surgical technique animation fda clearance. Spinal fusion, interbody cage, tlif, degenerative lumbar disease. The surgical options for interbody fusion of the lumbar spine include.
Tlif is designed to eliminate the disc as the source of mechanical back pain. After the box annulotomy, a pituitary rongeur is used to initially remove loose nuclear tissue in. Clinical benefits xlif is the only lateral approach procedure proven by over 10 years of clinical evidence. Lumbar spondylosis may result in mechanical back pain, radicular and claudicant symptoms, reduced mobility and poor quality of life. Degenerative disc and facet joint disease of the lumbar spine is common in the ageing population, and is one of the most frequent causes of disability. Pdf transforaminal lumbar interbody fusion tlif is a common procedure performed by spine surgeons. Mobbs and others published l5s1 anterior lumbar interbody fusion technique find, read and cite all the research you need on researchgate. The tlif implant is available in a 25mm length x 10mm width footprint, and is provided with and without lateral windows. Miniopen transforaminal lumbar interbody fusion through a.
Transforaminal lumbar interbody fusion humantech spine. The disc space is most efficiently, thoroughly and repro ducibly prepared for interbody fusion by using a threestep process. Royal oak ibfd system surgical technique transforaminal. All surgical techniques are available as pdf files at. Capstone peek spinal system plif and tlif surgical technique. Cavicchioli5 abstract transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrode. A mas tlif achieves this by using a less invasive approach to fuse one or more vertebrae together to reduce their motion. Pdf minimally invasive transforaminal lumbar interbody fusion. Optimus, anterior lumbar fusion system sales sheet tech sheet. However, mis tlif is a technically challenging procedure. Tm300 tlif device table of contents implant description 4 preoperative 4 patient positioning 4 exposure 4 identify location 4 placing pedicle screws 4 harvesting autograft 4 surgical procedure 5 disc exposure and decompression 5 annulotomy and discectomy 5 distraction and endplate preparation 7 implant selection 7. If you have objections to receiving blood products, please let us know. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. Operative complications associated with mitlif are similar to those of open tlif.
Typically, cage insertion is performed from the symptomatic side in patients with radiculopathy or the concave side in patients with coronal deformity. Degenerative lumbar spondylolisthesis sanjay yadla, md. Ecd expandable corpectomy device surgical technique depuy synthes 15 7. Tlif procedure is performed through a posterior incision. Tlif versus plif in spondylolisthesis maastricht university. Extreme lateral interbody fusion xlif is a relatively new technique whereby access to the disc space is achieved through a minimally invasive lateral, retroperitoneal, transpsoas approach. Perioperative data duration of procedure, intraoperative blood loss, post.
Threaded cylindrical cages made of titanium, cortical allograft donor bone or synthetic bone. Over 400 published clinical studies support the procedure, documenting positive clinical. Conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations are known to produce mechanical pain and may be indications for a spinal fusion. The remaining steps in this surgical technique are similar in both open and minimally invasive surgical approaches. The current main techniques of posterior lumbar interbody fusion plif surgery all incorporate a supplementary intervertebral implant. As surgeons become more proficient in the operation and as surgical technique is refined, sensory dysesthesias and psoas trauma associated with the procedure are becoming less prevalent. Given the persistent neurological symptoms and evidence of spinal instability the patients is scheduled to undergo a minimally invasive transforaminal lumbar interbody fusion mis tlif.
Be sure to verify your new user account in the next 24 hours, by checking your email and clicking the verify link. With a good access surgical team, the complications associated with alif are minimal extreme lateral interbody fusion is a relatively new procedure. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the. Rafoo chakkarfun on the run 2012 full movie in hindi free download. However, the tlif procedure places a single bone graft between. Although the plif technique from a bilateral approach is wellknown in the clinical and academic literature, the development of the unilateral transforaminal lumbar interbody fusion tlif technique has allowed the surgeon to approach the interbody disc space posteriorly in a more efficient and isolated fashion, thereby diminishing the overall. Adjust the table as needed so that the carm provides true ap images when at 90 and true lateral images at 0.
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