A microsurgical technique for posterior lumbar interbody fusion: Technicalnote

Objective. To describe a microsurgical modification of the Ray Threaded Fus ion Cage (TFC) instrumentation technique for achieving lumbar interbody fus ion. Technique. The lumbar fusion is established by application of two titanium cages through two different short skin incisions, first on one and then on the other side. The spinous processes and the whole interspinous ligament a re preserved. Under microscopic control, the lower nerve root and foramen a re identified and foraminotomy performed. The dural sac is carefully expose d so that a free and gentle retraction of the nerve root to the midline can be: obtained. After removal of the disc material. the retractor is inserte d. Special attention should be paid to visualization of the superior nerve root in order to avoid neural injuries. The end plate and disc material are then drilled and tapped For insertion of the appropriate cage. Conclusion. The Ray TFC lumbar fusion can be practically and safely perform ed under microscopic control.