Novel Simultaneous Two-Surgeon Approach for Two Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: Application of a Tubular-based Camera

Abstract

Introduction Continuing efforts in spine research and development are essential to establish, maintain and evolve minimally invasive surgery (MIS). MIS applications in spine surgery are the result of a persistent and ongoing development of smart technologies, along with meticulous surgical training practices and the improvement of instruments and techniques. Thus, MIS approaches to the spine can benefit from novel technologies that reduce fluoroscopy utilization, operative time, surgeon fatigue, while potentially increasing cooperative strategies for challenging and multi-level surgeries. Clinical Presentation We describe two cases with the novel utilization of the tubular-based camera system to allow for two surgeons to work simultaneously in treating a patient that required a two-level transforaminal lumbar interbody fusion (TLIF) surgery for degenerative spondylosis at L4-5 and L5-S1. Conclusion In this case specifically, this approach was made possible with a tubular-based sterile camera which allowed for the two surgeons to work comfortably in concert, without encountering issues of visualization, collisions, and fatigue. With specific focus on radiation, operative time, and visualization, this technique specifically addresses some of the shortfalls of MIS spine surgery procedures, and could be considered as a first-line approach for two-level MIS TLIF surgeries.