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