Defining the MIS-TLIF: A Systematic Review of Techniques and Technologies Used by Surgeons Worldwide.
| Publication Type | Academic Article |
| Authors | Lener S, Wipplinger C, Hernandez R, Hussain I, Kirnaz S, Navarro-Ramirez R, Schmidt F, Kim E, Härtl R |
| Journal | Global Spine J |
| Volume | 10 |
| Issue | 2 Suppl |
| Pagination | 151S-167S |
| Date Published | 05/28/2020 |
| ISSN | 2192-5682 |
| Abstract | STUDY DESIGN: Systematic review. OBJECTIVE: To date there is no consensus among surgeons as to what defines an MIS-TLIF (transforaminal lumbar interbody fusion using minimally invasive spine surgery) compared to an open or mini-open TLIF. This systematic review aimed to examine the MIS-TLIF techniques reported in the recent body of literature to help provide a definition of what constitutes the MIS-TLIF, based on the consensus of the majority of surgeons. METHODS: We created a database of articles published about MIS-TLIF between 2010 and 2018. We evaluated the technical components of the MIS-TLIF including instruments and incisions used as well the order in which key steps are performed. RESULTS: We could identify several patterns for MIS-TLIF performance that seemed agreed upon by the majority of MIS surgeons: use of paramedian incisions; use of a tubular retractor to perform a total facetectomy, decompression, and interbody cage implantation; and percutaneous insertion of the pedicle-screw rod constructs with intraoperative imaging. CONCLUSION: Based on this review of the literature, the key features used by surgeons performing MIS TLIF include the use of nonexpandable or expandable tubular retractors, a paramedian or lateral incision, and the use of a microscope or endoscope for visualization. Approaches using expandable nontubular retractors, those that require extensive subperiosteal dissection from the midline laterally, or specular-based retractors with wide pedicle to pedicle exposure are far less likely to be promoted as an MIS-based approach. A definition is necessary to improve the communication among spine surgeons in research as well as patient education. |
| DOI | 10.1177/2192568219882346 |
| PubMed ID | 32528800 |
| PubMed Central ID | PMC7263344 |