Unilateral approach with two-cage insertion for full endoscopic transforaminal lumbar interbody fusion: technical report

Background The advantages of performing a transforaminal lumbar interbody fusion (TLIF) with two cages rather than a single cage include a larger cage-bone contact area and higher interbody stability. Methods A customized cage guide is docked in the disc space created after a total facet resection. The first cage is inserted deeply into the contralateral disc space. The second cage is then inserted using the cage guide device while protecting the exiting and traversing nerve roots. Conclusion We successfully inserted two cages from unilateral side during full endoscopic TLIF. This technique is recommended for L4–L5 and L5–S1 levels.