Small Incisions for Big Problems: Minimally Invasive Lumbar Spine Surgery MIS-TLIF Technique and Practice

In 1982, Harms et al. proposed the transvertebral foraminal approach to lumbar interbody fusion (TLIF), which only destroys the unilateral posterior structures of the lumbar spine and generally does not require intraoperative distraction of the nerve roots. In 1997, Foley and Smith proposed the tubular retractor technique, which solved the problem of minimally invasive access to the posterior spine and reduced the strain and stripping of the paravertebral muscles during routine posterior lumbar surgery. 2001, Foley proposed the percutaneous pedicle screw technique, and minimally invasive lumbar interbody fusion was introduced. 2002, Koo first reported minimally invasive transforaminal fusion of the lumbar spine. Koo first reported the minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PLIF) technique, and in 2003, Foley first reported the minimally invasive transforaminal access lumbar interbody fusion (MIS-TLIF) technique. After nearly 10 years of development, MIS-TLIF has been continuously enriched and improved in terms of surgical techniques and indications, and has been accepted by more and more spine surgeons. Indications for surgery 1, lumbar spondylolisthesis (Meyding I / II) 2, discogenic low back pain 3, recurrent disc herniation with low back pain 4, post-discectomy intervertebral space collapse resulting in foraminal stenosis with nerve root compression. 5.Pseudarthrosis formation 6.Posterior lumbar lordosis after laminectomy. 7. Lumbar deformity with coronal/sagittal imbalance. Relative inverse indications 1. Multi-segmental disc involvement (>3 segments). 2. Severe osteoporosis. 3, severe central canal developmental stenosis 4, central disc calcification 5, severe and III-IV° spondylolisthesis.