Clinical Application of Microscope-Assisted Minimally Invasive Anterior Lumbar Interbody Fusion

Area of Science:

• Spine Surgery
• Minimally Invasive Techniques
• Surgical Instrumentation

Background:

• Anterior lumbar interbody fusion (ALIF) is a common spinal procedure.
• Minimally invasive approaches (Mini-ALIF) aim to reduce surgical trauma.
• Microscope assistance can enhance visualization during spinal surgery.

Purpose of the Study:

• To evaluate the technical aspects of microscope-assisted anterior decompression fusion.
• To introduce and assess a novel spreader system for Mini-ALIF.
• To determine the efficacy and safety of this technique.

Main Methods:

• Retrospective analysis of 42 patients undergoing microscope-assisted Mini-ALIF between July 2020 and August 2022.
• Utilized a novel spreader system for intervertebral space access.
• Repeated-measures ANOVA for comparing pre- and post-operative imaging indicators.

Main Results:

• Mean operative time: 143 minutes; mean blood loss: 180 mL.
• Postoperative foramen and disc height were significantly increased compared to pre-operative measurements.
• One case of peritoneal rupture; otherwise, no major complications reported over an 18-month follow-up.

Conclusions:

• The spreader-assisted micro-Mini-ALIF is technically feasible, simple, and effective.
• The system provides excellent disc exposure, visualization of critical structures, and adequate intervertebral space spreading.
• This technique aids in restoring intervertebral height and is particularly beneficial for surgeons with less experience.