True Percutaneous Transforaminal Lumbar Interbody Fusion: Case Illustrations, Surgical Technique, and Limitations.

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Citation: Journal of Neurological Surgery. 77(4):344-53, 2016 JulPMID: 26291889Institution: MedStar Washington Hospital CenterDepartment: NeurosurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Intervertebral Disc Degeneration/su [Surgery] | *Low Back Pain/su [Surgery] | *Lumbar Vertebrae/su [Surgery] | *Minimally Invasive Surgical Procedures/mt [Methods] | *Spinal Fusion/mt [Methods] | Adult | Bone Screws | Diskectomy/mt [Methods] | Humans | Male | Middle Aged | Treatment OutcomeYear: 2016ISSN:
  • 2193-6315
Name of journal: Journal of neurological surgery. Part A, Central European neurosurgeryAbstract: Copyright Georg Thieme Verlag KG Stuttgart . New York.Objective The last decade has seen significant advances in minimally invasive techniques for lumbar interbody fusion that have reduced approach-related morbidity. Percutaneous lumbar interbody fusion involves a posterior transforaminal approach to the disk space with a minimal access port through the Kambin triangle. This technique obviates the need for the facetectomy or laminectomy required in a traditional transforaminal approach. This article describes the surgical technique, potential advantages and limitations, and representative case illustrations. Methods Percutaneous transforaminal interbody fusion was performed on two patients with axial back and leg pain as a result of degenerative disk disease. Diskectomy and interbody cage insertion were completed through a tubular dilator placed onto the disk space in the Kambin triangle. Posterior fixation was achieved with percutaneous transfacet screws. Clinical outcome and postoperative complications are discussed. Results Both patients demonstrated significant clinical improvement after surgery with>1year follow-up despite experiencing transient neurologic symptoms. Conclusion Although this report demonstrates the feasibility and advantages of the approach, the technique is limited by the potential for nerve root injury and pseudoarthrosis. All authors: Syed H, Voyadzis JMFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-04-11
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Journal Article MedStar Authors Catalog Article 26291889 Available 26291889

Copyright Georg Thieme Verlag KG Stuttgart . New York.

Objective The last decade has seen significant advances in minimally invasive techniques for lumbar interbody fusion that have reduced approach-related morbidity. Percutaneous lumbar interbody fusion involves a posterior transforaminal approach to the disk space with a minimal access port through the Kambin triangle. This technique obviates the need for the facetectomy or laminectomy required in a traditional transforaminal approach. This article describes the surgical technique, potential advantages and limitations, and representative case illustrations. Methods Percutaneous transforaminal interbody fusion was performed on two patients with axial back and leg pain as a result of degenerative disk disease. Diskectomy and interbody cage insertion were completed through a tubular dilator placed onto the disk space in the Kambin triangle. Posterior fixation was achieved with percutaneous transfacet screws. Clinical outcome and postoperative complications are discussed. Results Both patients demonstrated significant clinical improvement after surgery with>1year follow-up despite experiencing transient neurologic symptoms. Conclusion Although this report demonstrates the feasibility and advantages of the approach, the technique is limited by the potential for nerve root injury and pseudoarthrosis.

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