Transforaminal lumbar interbody fusion (TLIF) is an important surgical option for the treatment of back pain and radiculopathy. The minimally invasive TLIF (MI-TLIF) technique is increasingly used to achieve neural element decompression, restoration of segmental alignment and lordosis, and bony fusion. This article reviews the surgical technique, outcomes, and complications in a series of 144 consecutive 1- and 2-level MI-TLIFs in comparison with an institutional control group of 54 open traditional TLIF procedures with a mean of 46 months’ follow-up. The evidence base suggests that MI-TLIF can be performed safely with excellent long-term outcomes.
Key points
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Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) can decompress central and foraminal stenosis from a unilateral or bilateral approach.
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MI-TLIF permits 3-column arthrodesis from a single posterior incision.
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MI-TLIF techniques can be used to effectively reduce spondylolisthesis, increase disc height, and restore segmental lordosis.
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MI-TLIF has better perioperative outcomes and similar long-term outcomes when compared with open TLIF, with trends toward improvement in cost and functional outcomes in the minimally invasive cohort.
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Operative complications associated with MI-TLIF are similar to those of open TLIF, with some caveats: cerebrospinal fluid leak, infection, neurologic deficit, malpositioned instrumentation, and Kirschner-wire fracture.
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