Combined Minimally Invasive Transforaminal Lumbar Interbody Fusion and Minimally Invasive Laminectomy

Transforaminal lumbar interbody fusion (TLIF) is a well-established intervention for patients with spondylolisthesis and instability with compression of neural structures. Minimally invasive (MIS) TLIF has been proposed as potentially superior to a standard midline approach. For patients with both bilateral lateral recess stenosis and central stenosis, combining MIS-TLIF with MIS laminectomy allows for bilateral decompression, which is not usually afforded by standard TLIF, in addition to arthrodesis. This paper describes our technique for combining MIS-TLIF with MIS laminectomy, preserving midline structures and accomplishing decompression and arthrodesis via a unilateral approach. The use of CT-guided navigation in our technique significantly decreases radiation exposure to the surgical team compared with standard fluoroscopic techniques. Surgeons may consider this technique when treating patients with lumbar spondylolisthesis and instability who desire preservation of midline structures.