Abstract—Transforaminal lumbar interbody fusion (TLIF) surgeries have nowadays became popular for treatment of degenerated spinal disorders. The interbody fusion technique like TLIF maintains load bearing capacity of the spine and a suitable disc height. Currently many techniques have been introduced to cure Spondylolisthesis. This surgery provides greater rehabilitation of degenerative spines. While performing this TLIF surgery existing methods use guideway, which is a troublesome surgery technique as the use of two separate instruments is required to perform this surgery. This paper presents a concept which eliminates the use of guideway. This concept also eliminates problems that occur like reverting the cage. The concept discussed in this paper also gives high accuracy while performing surgery. Keywords—Degenerative disc diseases, pedicle screw, spine, spondylolisthesis, transforaminal lumbar interbody fusion. I. INTRODUCTION PPROXIMATELY 70 years ago, a surgery which has evolved as a treatment for lumbar spinal fusion, was introduced. In the early 1990s, Harms and Jeszenszky described Transforaminal Lumbar Interbody Fusion (TLIF) surgeries to heal spinal disorders. Degenerative Disc Diseases (DDD) most commonly occurs due to aging of the spine. It is also caused due to injury to the back as the result of accidents, sudden shock. Reduction in protein content can also lead to Degenerative Disc Diseases [1]. DDD causes reduction in water-attracting molecules, and hence, water in the disc to decrease. This reduces the disc’s ability to handle back movement and also induces pain. So spinal fusion surgeries are performed to stop motion at a painful vertebral segment and that should decrease the pain generated from the joint [3]. Lumbar fusion surgeries are performed for DDD, in cases where the diseases are not possibly cured by physical exercises and medicines, the surgeries are highly recommended. The main objective of this surgery is to create solid bone between two vertebrae [3]. This reduces excessive pain which is caused by immoderate stress [1]. While performing this surgery a special spacer called a TLIF cage is inserted into two vertebrae. These surgeries are performed using medical tools. Some surgeries make use for one tool for insertion and another tool for guiding the cage. There are different approaches towards this spinal fusion surgery which involves adding a Sangram A. Sathe, Neha A. Madgulkar and Shruti S. Raut are with the Department of Mechanical Engineering, MIT College of Engineering, Kothrud, Pune, Maharashtra 411038,India S. P. Wadkar is with the Department of Mechanical Engineering, MIT College of Engineering, Kothrud, Pune, Maharashtra 411038, India (e-mail: swapnilwadkar1982@gmail.com). bone graft material to a segment of the spine, set up a biological response that causes the bone graft to grow between the two vertebral elements to create a bone fusion and finally the boney fusion - which results in one fixed bone replacing a mobile joint – stopping the motion at that joint segment. Bone fusion rates are enhanced because the bone graft is placed in the disc space and gutters of the spine posteriorly. There are two methods of achieving an interbody fusion which are posterior lumbar interbody fusion (PLIF) and TLIF [2]. Fig. 1 Difference in TLIF and PLIF surgery The main advantage of the TLIF procedure compared with the PLIF procedure included a decrease in potential neurological injury and preservation of posterior column integrity through minimizing lamina, facet, and parts dissection. A cage consists of axial hollow space in which bone graft is added. Bone graft merges into a single solid bone. A cage is made up of PEEK (Poly Ether Ether Ketone) material. Its thickness ranges from 6 mm to 13 mm and is selected on the basis of requirement of the case. Its breadth is 14 mm and length 28 mm. Lordotic angle is 50. Alternatives for PEEK are carbon fiber and Titanium mesh [2]. The main parameter in the surgery is the cage location. The location in intervertebral disc space is important. It is useful for determining lumbar lordosis. In some cases, due to the requirement according to patients, only a convex-shaped cage is used. The curved cage was designed as a bullet-type convex- shaped implant. This design is achieved so as to help the cage fit to the convexity of the vertebral endplate. The convex- shaped cage may have some advantages such as equivalent lordosis correction and tight endplate fitting [4]. Concept of Transforaminal Lumbar Interbody Fusion Cage Insertion Device Sangram A. Sathe, Neha A. Madgulkar, Shruti S. Raut, S. P. Wadkar A World Academy of Science, Engineering and Technology International Journal of Biomedical and Biological Engineering Vol:11, No:2, 2017 59 International Scholarly and Scientific Research & Innovation 11(2) 2017 scholar.waset.org/1307-6892/10006485 International Science Index, Biomedical and Biological Engineering Vol:11, No:2, 2017 waset.org/Publication/10006485