MIS-TLIF revision surgery for postoperative interbody fusion cage migration via contralateral intervertebral foramen approach: A case report.

RATIONALE: Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is widely applied for lumbar spine disorders due to reduced surgical trauma and faster recovery. However, postoperative interbody fusion cage migration remains a challenging complication. This report introduces a contralateral intervertebral foramen revision strategy as an alternative solution to correct cage migration without removing the original cage.

PATIENT CONCERNS: A 55-year-old Asian female presented with progressive lower back pain, radiating leg pain, and limited mobility 5 weeks after MIS-TLIF. Symptoms significantly affected daily activities and were consistent with neurological compression.

DIAGNOSES: Postoperative cage migration with associated nerve compression was confirmed by physical examination and imaging studies, including X-ray, computed tomography, and magnetic resonance imaging.

INTERVENTIONS: A revision MIS-TLIF procedure was performed via the contralateral intervertebral foramen. The migrated cage was repositioned using the original cage handle and Kirschner wire, and an additional interbody cage was implanted to enhance segmental stability. This approach avoided removing the original cage and minimized anatomical disruption.

OUTCOMES: Neurological symptoms improved immediately after surgery, and postoperative imaging confirmed satisfactory cage correction and stabilization. At the 1-year follow-up, the patient reported no recurrent discomfort, and computed tomography imaging demonstrated stable cage position and interbody fusion.

LESSONS: Contralateral intervertebral foramen access in MIS-TLIF revision surgery offers a minimally invasive alternative for cage migration management, avoiding the need for cage removal and reducing operative trauma. This technique may provide a viable option for similar revision scenarios requiring neural decompression and cage repositioning.