Minimally Invasive Lumbar Posterior Interbody Fusion

Minimally Invasive Lumbar Posterior Interbody Fusion: Revolutionizing Spinal Fusion Surgery

Minimally invasive lumbar posterior interbody fusion (MI-RLF) is a cutting-edge surgical technique that offers significant advantages over traditional open and navigated minimally invasive interbody fusion techniques.

This advanced procedure uses sophisticated imaging technology to achieve greater precision, improve patient outcomes, and reduce recovery times.

In this article, we will explore the various interbody fixation options, indications, techniques, benefits, and risks of MI-RLF and discuss the advantages of expanding interbody cages compared to traditional options.

Interbody Fixation Options

Several interbody fusion techniques are available, each with its unique approach to accessing the spine and stabilising the affected vertebrae. These techniques include:

• Posterior lumbar interbody fusion (PLIF): This technique involves accessing the spine from the back and removing the affected disc through a posterior approach.
• Transforaminal lumbar interbody fusion (TLIF): Similar to PLIF, this technique accesses the spine from the back, but it does so through a single incision on one side of the spine, minimising disruption to the spinal muscles.
• Lateral lumbar interbody fusion (LLIF): This technique involves accessing the spine from the side, again allowing for less disruption to the spinal muscles and nerves.

Indications

MI-RLF is indicated for patients with a variety of spinal conditions causing chronic pain and instability, including degenerative disc disease, spondylolisthesis, spinal stenosis, and recurrent disc herniations.

This procedure is recommended for patients who have not found relief through conservative treatments and may be especially beneficial for those who require multi-level fusions or have previously undergone spinal surgery.

Technique

MI-RLF utilises assistance to provide precise, real-time guidance throughout the surgical procedure. After the patient is placed under general anaesthesia, the surgeon makes a small incision in the back and inserts a tubular retractor to create a working channel for the surgical instruments. 

The advanced imaging system helps the surgeon visualise the spine and accurately remove the damaged disc, prepare the endplates for fusion, and insert an interbody cage filled with bone graft material.

Benefits of MI-RLF

• Enhanced precision: Assistance allows for increased accuracy in the placement of interbody cages and pedicle screws, reducing the risk of complications.
• Smaller incisions: MI-RLF requires smaller incisions than traditional open procedures, resulting in less tissue damage and blood loss.
• Shorter hospital stays: Patients who undergo MI-RLF typically experience shorter hospital stays and a quicker return to normal activities.
• Reduced risk of complications: The minimally invasive approach and advanced imaging technology used in MI-RLF decrease the risk of infection, nerve damage, and blood loss.

Expanding Interbody Cages: A Game-Changer

Expanding interbody cages represent a significant advancement in spinal fusion surgery.

These innovative devices can be adjusted to fit the patient's unique anatomy, providing optimal spinal support and promoting fusion. The benefits of expanding interbody cages include:

• Customisable spinal support: Expanding interbody cages can be adjusted to match the patient's unique anatomy, optimising spinal alignment and stability.
• Reduced risk of subsidence: The ability to expand the cage may reduce the risk of the cage sinking into the vertebral body, a complication that can occur with interbody cages.
• Reduced risk of nerve injury: It is argued that the cage's smaller size at the time of insertion allows it to pass by the adjacent nerve with less risk of nerve injury.

Risks

As with any surgical procedure, MI-RLF carries potential risks, including infection, bleeding, nerve injury, and nonunion or malunion of the fused vertebrae. However, the minimally invasive nature of MI-RLF and the use of assistance aims to reduce the likelihood of these complications.

Minimally invasive lumbar posterior interbody fusion represents a major advancement in spinal fusion surgery. By harnessing the power of assistance and advanced imaging technology, MI-RLF offers increased precision, reduced tissue damage, and improved patient outcomes compared to traditional open and navigated minimally invasive techniques.

Patients suffering from chronic back pain and spinal instability should consider consulting with a spine surgeon experienced in MI-RLF to discuss their options and determine if this revolutionary procedure is right for them.

As spinal surgery continues to evolve and incorporate new technologies, the future of minimally invasive spine surgery looks promising. It would offer patients a safer and more effective path to pain relief and restored function.