Purpose of Technology: Minimally invasive transforaminal lumbar interbody fusion (MITLIF) employs laparoscopic surgical techniques along with muscle dilation procedures to insert bone grafts and/or medical devices between 2 or more adjacent spinal vertebrae in order to stabilize them and initiate a biological response that will fuse the vertebrae, in an effort to provide continued support to the spinal column and reduce the pain associated with spinal disease or injury.

Controversy: MITLIF provides a minimally invasive alternative to open transforaminal spinal fusion surgery, with substantially less opportunity for soft tissue trauma and damage due to neural retraction. The minimally invasive nature of the approach should confer less risk for procedure-related complications. MITLIF is a technically demanding procedure and carries a significant learning curve, which may lead to a wide range of perioperative and adverse outcomes. MITLIF has not been definitively established as a true alternative to open transforaminal lumbar interbody fusions (OTLIF), particularly with regard to long-term outcomes.

Relevant Questions:

  • Does MITLIF more effectively mitigate pain and/or disability associated with lumbar disc disease compared with OTLIF?

  • Are operative parameters (operative time, perioperative blood loss, or hospital length of stay) lower with MITLIF compared with OTLIF?

  • Is MITLIF safe?

  • Have definitive patient selection criteria been established for MITLIF for treatment of lumbar disc disease?


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