Mini open transforaminal lumbar interbody fusion motlif is a powerful minimally invasive surgical mis technique that achieves decompression, interbody fusion, posterolateral fusion, pedicle screw instrumentation and lowgrade spondylolisthesis reduction table 1. Expedium surgical technique by apolineo comunicacion. Transforaminal lumbar interbody fusion tlif in revision. Minimally invasive transforaminal lumbar interbody fusion. Position the rod holder handle to be as parallel as possible to the skin surface, with the rod parallel to the axis of the slots of the extension perpendicular to the skin. Effect of minimally invasive technique on return to work and. Transforaminal lumbar interbody fusion motlif surgical.
Includes valuable tips on insertion techniques and complication avoidance to maximize success in. Following the corrective reduction maneuvers, a structural interbody fusion device may be inserted via a plif or tlif procedure, if required. Opal surgical technique depuy synthes 1 indications and contraindications intended use opal is an implant system for a unilateral transforaminal approach tlif or optionally for a bilateral posterior approach plif. Maximum access surgery mas transforaminal lumbar interbody fusion tlif is a surgical procedure that was developed to provide spinal stability and help. Adam lewis was the first surgeon to perform a case with the variliftlx system. At golden state orthopaedics we believe that movement is the very foundation of peoples health and well being. Maximum access surgery mas and transforaminal lumbar interbody fusion tlif. Variability of plus or minus 15 degrees in both neck angle and version allow the surgeon to restore individual patient anatomy. A microdiscectomy is a surgical technique that involves use of magnification to carefully dissect tissues and remove a disc fragment from the spinal canal.
Watch this video to learn more about using the sigma tc3 rp with mbt for revision surgeries and stem extensions. Shoulder arthroplasty system tsa surgical technique. Minimally invasive transforaminal lumbar interbody fusion at. Minimallyinvasive midline posterior interbody fusion with. Through a program of continuous development depuy now offers a single system of sigma high performance instruments that supports most approaches to knee replacement surgery. Coda plif spacercadence plif spacertraxis surgical technique chapter 8. The quantitative analysis of tissue injury markers after miniopen lumbar fusion. Cavicchioli5 abstract transforaminal lumbar interbody fusion tlif is a relatively new technique of lumbar arthrode. Discovery translaminar facet screw fixation depuy spine chapter 140.
Surgical technique page 05 introduction page 06 templating and preoperative planning page 08 surgical approach anterolateral page 12 surgical approach posterolateral page 15 femoral resection page 15 acetabular exposure page 16 acetabular reaming page 18 acetabular shell trialing and positioning page 21 acetabular trial liners page 22. Appendix iv, surgical technique, edited by william l. Clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion. The information and image included herein is the property of.
Tlif procedure is performed through a posterior incision. As with all surgical procedures, the technique used in each case will depend on the surgeons medical judgment as the best treatment for each patient. Minimally invasive transforaminal lumbar interbody fusion mitlif and lateral mass fusion with the metr x system chapter 141. Interbody fusion device may be inserted via a plif or tlif. Place the cage in the graft support and lock the cage by turning the graft support knob. Cut the transforaminal window prepare a window for transforaminal approach, using the osteotomes 389. Isass12 full abstract book isass the international society for. Expandable tlif and plif technology surgical technique. Either a qualified spine surgeon or a vascular surgeon performed the anterior approach to the lumbar spine in the alif and ap fusion groups.
Advancing science, enhancements were made to corail to provide solutions for orthopaedic surgeons treating todays higherdemand patients. A minimally invasive technique of midline exposure limited only to the facets and fixation with laterally directed cortical bone trajectory cbt screws was introduced with the intent of. Sizing and placement 16 removal and revision 22 tm ardis implants 23 tm ardis instruments 24 kit contents 26 important information on the tm ardis interbody system 31. Avenue t tlif cagesurgical technique guide 9 cage preparation knob step 6 the graft fusion chamber must be filled with allograft or autograft. Center the resection guide along the neutral axis of the femur and mark the resection line. The patient can be positioned in either a lateral or supine position depending on surgeon preference.
It is specially designed for small incision, resulting in a relatively atraumatic operation for the patient. Interbody systemsurgical technique guide 3 device description 4 tlif. Many surgical procedures have been used to realign the knee extensor mechanism. A conventional tlif procedure can now be accomplished. This content is intended for health care professionals in the united states. Handbook of surgical technique 97803234620 us elsevier.
Minimally invasive lumbar fusion surgery mis tlif youtube. Jordy winters, emea spine lead, depuy synthes, shares his. Surgical technique tlif overview once the tube is placed in the proper position and with appropriate trajectory for a tlif, begin to remove residual soft tissue in a standard manner utilizing electrocautery and other standard instruments. Transforaminal lumbar interbody fusion tlif was re. The unilateral transforaminal lumbar interbody fusion tlif represents an alternative surgical technique avoiding both the anterior approach and the approach through the spinal canal. Indications indications are lumbar and lumbosacral pathologies in which segmental spondylodesis is indicated, for example. We offer one of the worlds most comprehensive portfolios of orthopaedic products and services in the areas of joint reconstruction, trauma, spine, sports medicine, craniomaxillofacial, power tools and biomaterials. However, the tlif procedure places a single bone graft between. Direct lateral interbody fusion transpsoas approach dlif surgical technique instrument set 2 preoperative planning 7 nimeclipse spinal system needle electrode placement 8 patient positioning 10 localization 12 dissection to the psoas neuromonitoring through the psoas 14 dilation 16 retractor placement 16 disc preparation 19 trialing 23. Large bone graft windows are located through the body of the device to allow for. Tlif back surgery is done through the posterior back part of the spine. As with all surgical procedures, the technique used in each case will depend on the surgeons medical judgment as to the best treatment for each patient. Multiexpandable cage for minimally invasive posterior lumbar.
While discectomy is a technique that has been performed for many years, the use of very small incisions minimally invasive and specialized instruments is rather recent. In patients with chronic disabling lbp unresponsive to nonsurgical therapies, or those who develop instability in the process of decompressing neural compression, lumbar interbody fusion with rigid fixation is a surgical option that removes paingenerating compressive tissue, eliminates painful segmental motion, and restores sagittal balance. Coda plif spacercadence plif spacertraxis surgical technique. The instruments, technique and components of this arthroplasty system are designed to address these challenges. First implantation of the interbody fusion variliftlx device. Pedicle screw misplacement is a potential complication of instrumented spinal fusion, which can lead to neurologic injury. Tlif transforaminal lumbar interbody fusion nicandro figueiredo 1, johnny wesley g. Lumbar transforaminal lumbar interbody fusion tlif.
An adaptation of the posterior lumbar interbody fusion plif technique first described by cloward, the t. Proximally, insall realignment or variations with imbrication of the vastus medialis obliquis vmo and medial patellar retinaculum, combined with a lateral release, have been used extensively to improve patellar tracking. This publication is not intended for distribution in the usa. Minimally invasive surgical technique for treatment of cervical. Duraloc option ceramic acetabular cup system surgical technique the primary goal of total hip arthroplasty is the anatomic reconstruction of the hip joint, resulting in. This surgical technique provides instruction on the implantation of the sigma family of fixed bearing and rotating platform knees utilising. The ci depuy asr technique is a headonly procedure. Duraloc option ceramic acetabular cup system surgical technique the primary goal of total hip arthroplasty is the anatomic reconstruction of the hip joint, resulting in favorable prosthetic joint load and function.
Conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations are known to produce mechanical pain and may be indications for a spinal fusion. The tlif implant consists of banana shaped blocks in a parallel configuration of various heights 8mm 16mm, in 2mm increments. Thats why we provide medical professionals with the innovative products they need to assist them in treating their patients. Expedium surgical technique by apolineo comunicacion issuu. Royal oak ibfd system surgical technique transforaminal. Pinnacle acetabular cup system surgical technique golden. Its fully anatomic design and straightforward surgical technique assist the surgeon to achieve appropriate joint biomechanics, implant stability and range of motion for their patients. Kavoussi, provides students, residents, and clinicians with a firm foundation in the core techn.
Depuy spine is a joint venture with biedermann motech gmbh. Compact the draft in the bone graft chamber of the cage using the graft compactor figure 6. Impacted cages made of titanium, carbonfiber reinforced or plain peek polymer polyetheretheketone. It not only highlights the newest devices, but also the clinical guidelines needed to choose and apply the best implant for any surgical situation. Transforaminal lumbar interbody fusion tlif back surgery. The x25 hexlobe driver should be used to center the intermediate tightener. The current main techniques of posterior lumbar interbody fusion plif surgery all incorporate a supplementary intervertebral implant. Insert the rod into the cephalad slot of the exten sion. A transforaminal lumbar interbody fusion tlif is performed to remove a portion of a disc that is the source of back or leg pain. The cut will be approximately 1 cm above the lesser trochanter. Full details on surgical exposure are provided in the standard depuy asr. The variliftlx system is ideally suited for minimally invasive lumbar fusion surgery, he said. Sep 28, 2016 in patients with chronic disabling lbp unresponsive to nonsurgical therapies, or those who develop instability in the process of decompressing neural compression, lumbar interbody fusion with rigid fixation is a surgical option that removes paingenerating compressive tissue, eliminates painful segmental motion, and restores sagittal balance.
The future of spine surgery perspectives and trends to look out for. Pinnacle surgical technique depuy synthes 1 contents introduction 3 surgical technique templating and preoperative planning 4 acetabular reaming 6 acetabular cup trialling and positioning 7 implanting a pinnacle primary cup 10 polyethylene trial liners 11 alternative trial bearings 12 polyethylene liner configurations. From patient preparation to hand washing, from equipment to basic surgical procedures, this highly practical manual by drs. Theoretical advantages of tlif include increased fusion success, more complete foraminal decompression, better correction of deformity, and more effective treatment of discogenic pain. Mis spine system adaptable mis solutions for an evolving. Although a first detailed description of the tlif technique was given by harms and jeszenszky 14 as early as 1998 the number of published papers concerning its outcome and complications is limited. Tlif is designed to eliminate the disc as the source of mechanical back pain. Avenue t tlif cage surgical technique guide zimmer biomet. Clear indications or contraindications for the minimally invasive approach may lie in the comfort and proficiency of the particular surgeon. Degenerative disc diseases and spinal instabilities. Transforaminal lumbar interbody fusion tlif utilizes a more lateral window in order to access the interbody space without excessive dural retraction.
Surgical technique neck osteotomy the level of the neck resection is determined during preoperative templating. Like the plif posterior lumbar interbody fusion procedure, bone graft is used to fuse the spinal vertebrae after the disc is removed. Given this burden, opportunities exist for improvement in mis tlif procedures. In a mas tlif procedure, rather than starting from the middle of the back and. Standalone anterior lumbar interbody, transforaminal lumbar. Threaded cylindrical cages made of titanium, cortical allograft donor bone or synthetic bone. Over 250,000 doctors use vumedi to improve patient care and grow their practice. Along with an allinclusive list of the spinal instruments available today, the book offers direct comparisons of each system to help make an informed and confident selection.
A minimally invasive technique of midline exposure limited only to the facets and fixation with laterally directed cortical bone trajectory cbt screws was introduced with the intent of decreasing surgical morbidity. Minimally invasive transforaminal lumbar interbody fusion in. This surgical technique uses a standard posterior approach for illustration purposes. Coda plif spacercadence plif spacertraxis surgical technique sturmsnyderwebb spiral radius sr 90d instrumentation murreydarden discovery translaminar facet screw fixation depuy spine thalgottgiuffredrake minimally invasive transforaminal lumbar interbody fusion mitlif and lateral mass fusion with the metrx system tredway. The tlif implant is available in a 25mm length x 10mm width footprint, and is provided with and without lateral windows. Revision surgical technique using sigma tc3 rp with mbt. Tlif back surgery indications and technique spinehealth.
Perform the osteotomy, taking care to maintain the correct angle figure 1. Washington, university of pennsylvania and depuy orthopaedics, inc. Minimally invasive transforaminal lumbar interbody fusion mi tlif. A new final chapter on surgical craftsmanship brings the skills all together for the surgeon in the operating theatre, uniting and applying the relevant factors in the correct sequence and focussing on getting it right first time. The following general surgical technique guide is for illustrative purposes only. Along with an allinclusive list of the spinal instruments available today, the book offers direct comparisons of each system to. Minimally invasive transforaminal lumbar interbody fusion mitlif. Minimally invasive techniques for lumbar spinal fusion, including transforaminal lumbar interbody fusion mis tlif have recently been introduced with the goal of smaller operative wounds, less tissue trauma, and faster postoperative recovery when. Maximum access surgery transforaminal lumbar interbody fusion. A comprehensively updated text takes account of new developments in surgical techniques and equipment. More recently pimenta popularized the lateral approach to interbody fusion, or extreme lateral interbody fusion xlif. Surgical technique guide tlifplif using expedium di polyaxial screws screw shank angulation can be locked by tightening the outer blue set screw of the closure mechanism using the cannulated thandle intermediate tightener. Minimally invasive pedicle screw fixation utilizing oarm. This provides surgeons with a method to perform tlif procedures with a 2.
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