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Updated: Jun 6, 2026
Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Minimally invasive transforaminal lumbar interbody fusion: a review of techniques and outcomes
Isaac O Karikari1, Robert E Isaacs
1Division of Neurosurgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA. robert.isaacs@duke.edu
Study Design:
Review of published literature.
Objective:
To review the available medical literature reporting results after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and evaluate functional and radiographic outcomes with those following open TLIF and open posterior lumbar interbody fusion (PLIF) procedures.
Summary Of Background Data:
Minimally invasive spine techniques aim to reduce approach-related surgical morbidity without compromising operative and clinical outcomes. MIS TLIF is increasingly being used for the management of various lumbar degenerative diseases. Despite the limited number of well-designed clinical studies, the available published data suggest potential advantages over its open posterior-approach lumbar interbody fusion counterparts. Such benefits include less intraoperative blood loss, less need for blood transfusions, shorter hospital course, and less postoperative pain.
Methods:
Literature examining posterior-approach interbody fusion techniques (PLIF, TLIF, and MIS TLIF) was collected using the National Center for Biotechnology Information database and PubMed/MEDLINE, and summarized for discussion.
Results:
Literature reports of MIS TLIF generally show comparable or improved clinical outcomes when compared with those following open posterior interbody fusion techniques. Additionally, significantly less blood loss, hospital stay, and complications were generally reported, despite slightly longer duration of surgery, especially during early cases in a surgeon's experience.
Conclusion:
More studies designed to provide class I or II data will be needed in the future to further solidify the favorable results observed so far with the MIS TLIF procedure.
Insights
Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) shows comparable or improved outcomes versus open techniques. MIS TLIF offers benefits like reduced blood loss and shorter hospital stays, though surgery may take longer.
Area of Science:
- Spine surgery
- Minimally invasive procedures
- Orthopedics
Background:
- Minimally invasive spine surgery (MIS) aims to decrease surgical morbidity.
- MIS TLIF is increasingly adopted for lumbar degenerative diseases.
- Potential benefits of MIS TLIF include reduced blood loss, transfusion needs, hospital stay, and pain.
Purpose of the Study:
- To review literature on MIS TLIF outcomes.
- To compare functional and radiographic results of MIS TLIF with open TLIF and PLIF.
Main Methods:
- Literature search of posterior-approach interbody fusion techniques (PLIF, TLIF, MIS TLIF).
- Data collected from NCBI database and PubMed/MEDLINE.
- Summarized findings for comparative discussion.
Main Results:
- MIS TLIF demonstrates comparable or superior clinical outcomes to open posterior interbody fusion.
- Significantly less blood loss, shorter hospital stays, and fewer complications reported for MIS TLIF.
- Slightly longer surgical duration noted for MIS TLIF, particularly in early surgical experience.
Conclusions:
- MIS TLIF shows favorable results compared to open techniques.
- Further high-quality studies (Class I or II evidence) are needed to confirm these findings.
- Additional research will solidify the benefits of MIS TLIF.
