MITLIF Operative Nuances- Step by Step
Vamsi Krishna Yerramneni, Ramanadha Reddy Kanala, Swapnil Kolpakawar, Thirumal Yerragunta
Abstract
BACKGROUND: : MITLIF is popular among minimally invasive lumbar interbody fusion procedures. The common indications of MITLIF are Grade I and selected cases of Grade II spondylolisthesis, Failed Back Surgery Syndrome, spondylodiscitis and deformity correction. OBJECTIVE: : To describe the technical nuances of MITLIF along with an operative video of a case of L4-L5 Grade I Spondylolisthesis. SURGICAL PROCEDURE: : Two incisions of 2.5 cm length are made on either side, at the level to be operated and further access is created by muscle splitting. Screws, rods and cage(s) are placed through this corridor under fluoroscopic guidance. RESULTS: : This procedure has the advantages of minimal blood loss, less muscular trauma, retention of intact posterior ligamentous anatomy, shorter hospital stay, lesser CSF leak and infection rates when compared to the open approaches. CONCLUSIONS: MITLIF has emerged as the standard procedure replacing open approaches. Mastery of this approach is strongly recommended to spine surgeons.