Lumbar Interbody Fusion for Adjacent Segment Disease: An illustrative Case of The Transforaminal Approach (MIS-TLIF)

Abstract

The scope of minimally invasive surgical (MIS) strategies for management of spinal pathology continues to expand. MIS transforaminal lumbar interbody fusion (TLIF) is an attractive alternative for the management of adjacent level disease. It minimizes approach related morbidities and provides anterior column support at a location where all 3 columns are affected by the adjacent segment degeneration (ASD).Our surgical technique involves the cannulation of the pedicles with K-wires. This is followed by a facetectomy and foraminal decompression with subsequent discectomy and endplate preparation. The cage is inserted followed by pedicle screw placement. To illustrate this technique, we present to you a case of a 56-year-old Female with previous L2–S1 successful arthrodesis, treated with MIS TLIF of L1–L2 for new adjacent segment disc herniation.This chapter describes the effective use of MIS TLIF in the treatment of adjacent segment disease and offers a unique strategy in management of this problem.