Visualization in the Minimally Invasive Transforaminal Lumbar Interbody Fusion: From Tubular to Endoscopic Approaches

The transforaminal lumbar interbody fusion remains one of the most common surgical techniques used for spinal arthrodesis. Spine surgery over the last three decades has increasingly emphasized approaches that reduce tissue trauma, iatrogenic injury, and perioperative morbidity. The minimally invasive transforaminal lumbar interbody fusion approach represents an opportunity for surgeons to achieve that aim, with modalities that allow visualization through tubular retractors or spinal endoscopy. In this paper, the authors review the techniques and considerations underlying visualization within both methods, as well as provide summary of a hybrid system incorporating the advantages of both. Minimally invasive transforaminal lumbar interbody fusion modalities must be selected in accordance with patient factors to achieve optimal outcomes.