Creating a Solid Posterolateral Fusion for a Minimally Invasive Lumbar Spine Surgery

Study Design: A technique article. Objective: Minimally invasive lumbar spine fusion (MIS fusion) creates a biomechanical construct for bony healing while minimizing soft tissue injury. We offer a novel technique for augmenting fusion within the posterolateral elements of the lumbar spine, which include the facet joint and transverse processes. Background: Minimally invasive spinal fusions are designed to limit muscle dissection. We have outlined a process to perform a posterolateral fusion utilizing novel techniques for bone graft placement and creation of a fusion bed. Materials and Methods: The article summarizes the surgical technique for MIS fusion in the posterolateral elements. Three cases of a minimally invasive transforaminal lumbar interbody fusion, posterolateral fusion/decompression, and a posterolateral fusion in the setting of a lateral lumbar interbody fusion are presented. The associated 1-year postoperative computed tomography scans and patient-reported outcomes are shown. Results: The 3 cases of MIS posterolateral lumbar fusion demonstrate fusion mass formation. Patient-reported outcomes also show positive results compared with baseline values for the 3 illustrative cases. Conclusions: Posterolateral fusion using MIS techniques can be challenging for surgeons. Our novel technique of bone graft placement with creation of a fusion bed shows positive clinical results.