Transdural retrieval of retropulsed transforaminal lumbar interbody fusion cages

Author:

Lefever Devon1,Leveque Jean-Christophe1,Hanks Thomas Allen2,Sethi Rajiv K.1,Eley Nicholas C.1

Affiliation:

1. Virginia Mason Department of Neurosciences and Spine, Seattle, Washington, USA

2. University of Washington School of Medicine, Seattle, Washington, USA

Abstract

ABSTRACT Transforaminal lumbar interbody fusions (TLIFs) are performed for various lumbar spine pathologies. Posterior migration of an interbody cage is a complication that may result in neurologic injury and require reoperation. Sparse information exists regarding the safety and efficacy of a transdural approach for cage retrieval. We describe a surgical technique, in which centrally retropulsed cages were safely retrieved transdurally. A patient with prior L3-S1 posterior lumbar fusion and L4-S1 TLIFs presented with radiculopathy and weakness in dorsiflexion. Imaging revealed posterior central migration of TLIF cages causing compression of the traversing L5 nerve root. Cages were removed transdurally; the correction was performed with an all-posterior T10-pelvis fusion. Aside from temporary weakness in right-sided dorsiflexion, the patient experienced complete resolution in their radiculopathy and strength returned to its presurgical state by 3 months. The transdural approach for interbody removal can be safely performed and should be a tool in the spine surgeon’s armamentarium.

Publisher

Medknow

Reference9 articles.

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