We received an interesting case report from Dr Christian Morgenstern, PhD from Barcelona.
“Percutaneous/endoscopic fusion (TLIF) has had two major drawbacks in my opinion:
1) it requires an endoscope (you need the skills and it adds time to surgery)
2) it requires especially designed interbody cages
Point one we addressed long time ago by describing the percutaneous TLIF technique. I have not used an endoscope for a fusion for years, hence the name “percutaneous TLIF” (we only use the fluoro, no endoscope).
Point two: we have also addressed this recently and we are now placing standard interbody cages (used in open surgery) with percutaneous TLIF and a skin incision of < 10mm. Hence, no need for expandable or especially designed cages anymore. I believe that these two improvements make percutaneous TLIF a much more accessible and universal technique, like in this case of a 52 years-old female with a degenerative spondy at L4/L5 and central canal stenosis. I placed a standard interbody cage at L4/L5 in 20 minutes. I want to thank MaxmoreSpine (Hoogland Spine Products GmbH) for their support." For images click on the links below: Link 1
You can watch a video of the patient after surgery here.