Transforaminal Lumbar Interbody Fusion




Indications





  • Segmental instability requiring fusion for stabilization



  • Recurrent disk herniation



  • Symptomatic spinal stenosis with a significant back pain component that would benefit from fusion



  • Degenerative disk disease with a significant back pain component



  • Spondylolisthesis that is progressive, is symptomatic, or requires decompression with a need to fuse spondylolisthetic level



  • Correction of degenerative scoliosis requiring fusion segments



  • Salvage for pseudarthrosis of a previous intertransverse fusion or arthroplasty





Contraindications





  • Active infection



  • Short life expectancy



  • Severe osteoporosis



  • Blood dyscrasia





Planning and positioning





  • Anteroposterior and lateral plain films or computed tomography (CT) scan to evaluate bony anatomy



  • Dynamic (flexion-extension) x-rays to evaluate degree of motion or instability



  • Magnetic resonance imaging (MRI) to evaluate neural elements and soft tissue (e.g., disk)




    FIGURE 74-1:


    The patient is placed in the prone position with chest rolls on a Jackson table.



  • Fluoroscopy and neuromonitoring, including somatosensory evoked potentials or electromyography or both





Planning and positioning



Jun 15, 2019 | Posted by in NEUROSURGERY | Comments Off on Transforaminal Lumbar Interbody Fusion

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