A microsurgical technique for posterior lumbar interbody fusion: technical note

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Fusion Techniques

Background:

• Lumbar interbody fusion is a common surgical procedure for spinal instability.
• Traditional techniques may involve significant tissue disruption.
• The Ray Threaded Fusion Cage (TFC) offers a potential solution for stable lumbar fusion.

Purpose of the Study:

• To describe a microsurgical modification of the Ray Threaded Fusion Cage (TFC) instrumentation technique.
• To detail the application of TFC for achieving lumbar interbody fusion.
• To highlight the benefits of microscopic control in this procedure.

Main Methods:

• Utilizing two titanium cages inserted via separate short skin incisions.
• Preserving spinous processes and interspinous ligament.
• Performing microsurgical dissection, foraminotomy, and nerve root retraction under microscopic visualization.
• Preparing the disc space and endplates for cage insertion.

Main Results:

• The described technique allows for precise identification and protection of neural structures.
• Microsurgical control facilitates safe retraction of the dural sac and nerve roots.
• The procedure enables effective preparation of the endplates for cage fixation.

Conclusions:

• The modified Ray TFC technique for lumbar interbody fusion can be performed practically.
• The use of microscopic control enhances the safety of the procedure.
• This microsurgical approach offers a viable option for lumbar fusion.