Minimal invasive transforaminal lumbar interbody fusion and percutaneous pedicle fixation-A preliminary experience

Introduction: Standard techniques for lumbar decompression, fusion, and pedicle screw fixation involve open exposures, extensive muscle dissection, and posterior element destruction. The purpose of this study was to report the initial clinical experience with minimally invasive decompression, transforaminal interbody fusion, and percutaneous pedicle fixation of the lumbar spine. Aim: Transforaminal lumbar interbody fusion (TLIF), a unilateral posterior approach for achieving interbody arthrodesis, is performed through a unilateral facetectomy, which will expose the posterolateral disc space. To perform discectomy, distraction is through posterior element. After discectomy is done, a bullet-shaped cage is inserted into the interspace. After decompression and fusion, percutaneous pedicle fixation is applied with minimal manipulation and muscle dissection. Methods: Twenty-one patients (8 men and 13 women with age ranged from 39 to 86 years) underwent minimal invasive TLIF and pedicle screw fixation in which the rod insertion device was used. All patients underwent successful percutaneous fixation. Seven patients underwent single-level fusions, and 14 underwent two levels. All patients underwent preoperative radiographic and magnetic resonance imaging examination were then followed up with computed tomography after 12 months. Conclusion: The use of minimally invasive decompression, TLIF, and percutaneous lumbar pedicle screw placement in spinal patients offers several distinct advantages over conventional open surgery. It eliminates the need for a large midline incision and significant paraspinous muscle dissection. Pedicle screws and rod insertion are placed through stab incisions. Paraspinous muscles are bluntly split compared with complete dissection, leading to potentially shorter periods of hospital stay and recovery. Blood loss and tissue injuries are minimized. The goal of this minimally invasive surgery is to minimize approach-related morbidity while retaining the same results as more traditional invasive approaches. Certainly, preliminary experience with the procedure has been promising.