Novel Use of Transforaminal Lumbar Interbody Fusion Trial to Aid in Midline Placement of Lumbar Artificial Disc: A...

Lumbar artificial disc replacement (ADR) is an established motion-preserving surgical option for degenerative disc disease. Proper implant positioning has been associated with improved clinical outcomes, implant longevity, and reduced rates of postoperative complications. We describe a novel intraoperative technique using a transforaminal lumbar interbody fusion (TLIF) trial as a temporary lateral spacer to facilitate midline positioning of a lumbar ADR and prevent implant skiving (lateral deviation during insertion). In the case presented, repeated attempts at ADR placement resulted in lateral deviation of the implant; a TLIF trial was employed as a mechanical barrier, allowing successful positioning of the ADR. This technical note demonstrates the feasibility of utilizing a TLIF trial as an adjunctive tool to facilitate accurate coronal alignment of lumbar arthroplasty implants when standard insertion techniques prove challenging.