A Low-Cost Three-Dimensional Printed Retractor for Transforaminal Lumbar Interbody Fusion

The authors developed a low-cost surgical retractor to improve surgeon's comfort and facilitate pedicle screw insertion in transforaminal lumbar interbody fusion surgery. The retractor was designed using three-dimensional (3D) modeling software and produced with the help of a 3D printer. It was attached to a mechanic retractor arm. The retractor was anchored to the transverse process through a concave notch at its tip, visualizing the junction between the transverse process and the superior articular process. The gutter-shaped body of the retractor helped stay within the ideal trajectory during screw insertion. The retractor was tested in 20 patients undergoing transforaminal lumbar interbody fusion with satisfactory results. Future models will be generated suitable for surgery of the cervical and thoracic spine.