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VIDEO: Minimally invasive TLIF

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In this video from the Open Operating Theatre, Nils Hansen-Algenstaedt, MD, from OrthoCentrum Hamburg in Hamburg, Germany, discusses how to perform a minimally invasive transforaminal lumbar interbody fusion (TLIF) in a 52-year-old woman with persistent pain after L4-L5 discectomy.

Surgery begins with patient in the prone position. Before skin incision, pedicle entry points for screw insertion at L4-S1 are identified using fluoroscopic control. After blunt dissection, the facet joint in resected and a hemilaminectomy is performed. A crossover decompression of the dural tube and contralateral nerve root is performed to treat stenosis. The disc is removed, segmental disc height is identified and then the coronal alignment is achieved with placement of cages. The same procedure is performed at L4-L5, and reduction screws are placed bicortically over K-wires beginning at S1. Longitudinal rods are placed after complete instrumentation. Fusion graft mass is inserted from L4-S1. The wound is then closed.

This video is a teaching tool to help surgeons prepare for surgery or they can use it as a refresher on the surgical technique and indications for this surgery.