Minimally Invasive Transforaminal Lumbar Interbody Fusion with the Space-D Access System

The Space-D Access System is a new, minimally invasive surgery (MIS) retractor system that allows spine surgeons to perform transforaminal lumbar interbody fusion (TLIF) with intraoperative navigation. Unlike other retractors, this system allows distraction/compression and lateral retraction. This is the first description of the technical aspects of the Space-D Access System for MIS TLIF since its public debut in May 2021. This study introduces the components and applicability of the Space-D Access System and provides step-by-step instructions with visuals to perform a MIS TLIF using this novel device. The Space-D Access System, StealthStation, CD Horizon Solera Voyager, and an anatomic lumbar spine model were used to demonstrate the steps to successfully perform MIS TLIF. The components and applicability of the Space-D Access System are discussed. Detailed written instructions and visuals are provided in a stepwise fashion to complete MIS TLIF effectively and efficiently. The Space-D Access System is the only multifunctional device that allows tissue retraction and pedicle-to-pedicle distraction/compression while performing MIS TLIF. To our knowledge, this is the first paper to describe the device and its use for MIS TLIF with written instructions and visuals using an anatomic model.