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Updated: Aug 17, 2025

Novel Mini-open Transforaminal Lumbar Interbody Fusion
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The "In-Parallel" Technique for Awake, Bilateral Simultaneous Minimally Invasive Transforaminal Lumbar Interbody

Andrew K Chan1,2, Anika Gnaedinger1, Chakib Ayoub3

  • 1Department of Neurosurgery, Duke University, Durham, North Carolina, USA.

Operative Neurosurgery (Hagerstown, Md.)
|December 12, 2022
PubMed
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This summary is machine-generated.

A novel "in parallel" surgical technique allows for simultaneous, minimally invasive lumbar decompression and fusion in awake patients, expanding options for complex spinal conditions.

Area of Science:

  • Spine surgery
  • Minimally invasive surgical techniques
  • Regional anesthesia

Background:

  • Minimally invasive lumbar fusion and decompression are feasible under spinal anesthesia for limited pathology.
  • Extensive lumbar procedures in awake patients are limited by anesthetic duration concerns.

Observation:

  • A novel "in parallel" surgical approach was developed for simultaneous, multi-segment lumbar spine surgery.
  • This technique involved concurrent left-sided decompression and right-sided fusion performed by two surgeons.

Findings:

  • A dual-surgeon, "in parallel" minimally invasive approach for three-segment lumbar pathology was successfully performed.
  • The procedure combined a two-level decompression with a transfacet fusion in an 87-year-old patient.

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Implications:

  • This dual-surgeon, "in parallel" technique enables complex spine surgeries previously limited by anesthesia duration.
  • It offers a viable alternative for patients unsuitable for general anesthesia, expanding treatment possibilities.