Minimally invasive lateral tubular approach for revision of failed lumbar interbody fusion: illustrative cases.

backgroundInterbody cage failure is associated with loss of disc height, nerve compression, and pseudarthrosis, and often requires reoperation. Revision of failed interbody cages is challenging due to subsidence of the cage into the adjacent endplates, causing bony defects and granulation tissue, resulting in difficult exposure and a higher risk of complications. OBSERVATIONS: In this case series, the authors present 2 cases of symptomatic interbody cage failure successfully revised using a minimally invasive lateral approach. The first case utilized a transpsoas lateral approach to replace a failed L2-3 cage from prior transforaminal lumbar interbody fusion. The second case used an anterior-to-psoas oblique lateral approach to revise a subsided L3 corpectomy cage. Postoperatively, both patients had significant symptom improvement. LESSONS: A lateral lumbar interbody approach-with its direct access to disc space, possibility for a relatively large-footprint cage while avoiding scar tissue from a prior approach, and favorable safety profile-is a promising option for the revision of failed interbody cages. https://thejns.org/doi/10.3171/CASE25750.