The two most common types of Minimal Invasive Surgery (MIS) include TLIF and XLIF which is explained below:
Transforaminal lumbar interbody fusion (TLIF)is the one type of minimal invasive surgery that I want to discuss that can be employed for many lumbar conditions. TLIF employs disc removal and insertion of a stabilizing cage to restore disc height and permanently fuse damaged or displaced vertebrae in the lower back. Then stabilizing screws and small rods are inserted using fluoroscopic or image guidance through the same small incisions to provide long term stability and help to fusion to occur more rapidly. Unlike open surgery, The minimally-invasive TLIF approach allows the lumbar spine to be accessed through a small incision in the back with progressive muscle dilators that gently separates the muscles surrounding the spine rather than cutting them allowing minimal disruption of muscle and soft tissue. This procedure is much less traumatic to the surround structures and can lead to a more rapid recovery. Conditions listed above can be effectively treated with this minimal invasive approach. The goal of TLIF is to stabilize the spine by restoring disc height and fusing the vertebrae together, thereby enhancing spinal stability and alleviating nerve compression.
eXtreme Lateral Interbody Fusion (XLIF)is a relatively new type of minimal invasive surgery that is often used for many lumbar conditions. Cages are inserted through tubular retractors from the flank or side of the abdomen also using small incisions. This approach avoids an incision on the back and is very useful when there has been any previous back surgery. The cages are inserted into the disc spaces from the patient's side or laterally which completely avoids the spinal canal and nerve structures that are posterior to the discs. A wide variety of disorders can be treated including degenerative disc disease, spondylolisthesis (slipping vertebra), and degenerative scoliosis without disrupting the back muscles. Which of these procedures is most appropriate has to be properly determined for your particular condition. In some cases a combination of the TLIF and XLIF are used especially in problems that involve multiple spinal levels.
If you think you may be a candidate for one of these highly specialized procedures please contact me at my team email address TeamMcBride@orlandoortho.com.