08/13/2026
One of the more technically demanding revision cases I’ve done: an outpatient anterior retroperitoneal extraction of a non-union expandable titanium TLIF cage that had migrated into the neural foramen.
The challenge here isn’t just the extraction itself — it’s approaching from the front to remove hardware originally placed posteriorly, working carefully around the great vessels and neural structures in the retroperitoneal space, while keeping the exposure minimally invasive rather than defaulting to an open anterior approach.
Cage non-union and migration cases like this are relatively rare, but when they happen, approach selection matters as much as technique. Curious how others have handled anterior extraction in similar revision scenarios — anterior retroperitoneal, or do you find open exposure necessary depending on migration extent?