TLIF (transforaminal lumbar interbody fusion) is commonly used to treat spinal cord compression or nerve root compression, and spinal instability. The surgical procedure is only recommended once less invasive treatments like physical therapy, injections, and drugs have failed. A TLIF reduces back and leg pain by fusing two or more vertebrae together. After TLIF recovery, most patients report little or no back and leg pain.
What Is a Transforaminal Lumbar Interbody Fusion (TLIF)?
Transforaminal lumbar interbody fusion (TLIF) is a modern technique for fusing the spinal column. The four names of the process are respectively transforaminal, lumbar, interbody, and fusion. Transforaminal means “through an opening” and lumbar means “lower back.” Fusion means “stabilization of the spine.”
This procedure on the lower back involves taking out an intervertebral disc and connecting two or more vertebrae together with screws and a cage. It involves the decompression of nerves in the lower back, the removal of a facet joint, and the removal of the intervertebral disc. Pedicle screws are inserted into the adjacent and underlying bones to stabilize the disc level, and a bone-filled cage is inserted into the disc space to fuse the spine (interbody fusion).
When is Transforaminal Lumbar Interbody Fusion (TLIF) Performed?
Many spinal diseases, including degenerative disc disease, herniated discs, and spondylolisthesis, can be treated with TLIF. The surgery is recommended for patients who have these conditions:
Disc prolapse
Disc prolapse causing pressure on the nerve roots, when one or more of the following conditions exist:
- Previous surgery has been performed
- Back pain caused by discs (discogenic back pain) is significant
- Spine instability
- A simple removal of the disc could result in instability
Lumbar Canal Stenosis
Symptoms of lumbar canal and/or lateral recess stenosis include a significant amount of discogenic back pain is also present and an unstable spine. The instability could result from simple surgery to relieve nerve pressure.
Foraminal Stenosis
This condition occurs when a joint in the spinal canal enlarges, narrowing the cervical disc space. There is usually one nerve root on one side of the cervical spine affected by this type of spinal stenosis. If a fusion is not performed concurrently with decompression, instability may result.
Discogenic Lower Back Pain
Discs are the cushions that lie between the vertebrae (bones) in your spine. When they become damaged or dehydrated, they can cause pain and stiffness in your lower back.
Facet Joint Pain
Facet joints are small joints where two vertebrae meet each other at the front of your spine. They are responsible for helping your spine move as you bend or stretch. Facet joint pain is common in people with osteoarthritis and can make it difficult for them to move freely and comfortably throughout their day-to-day lives.
Procedure for Spine Fusion Using TLIF Technique
In TLIF surgery, the back of the spine is exposed through an incision on the posterior side. The patient will be under general anesthesia as the surgeon readies you for the procedure. The surgeon performs a TLIF procedure in the following stages:
Incision and Access to the Spine
As part of the surgical procedure, the surgeon makes an incision in the spine and removes part of the vertebral bone to access the damaged disc. Only one side of the disk can be accessed.
Removal of the Disc
As soon as the surgeon reaches the disc, they will remove it. There’s some disc wall left over so the bone graft can be contained.
Bone Graft Insertion
Most bone grafts are taken from the pelvis, or bone substitutes are used. The surgeon inserts a bone graft into the empty disc space. Bone grafts realign vertebrae and relieve nerve root pressure. If the disc space is empty, the surgeon may use a morselized bone to fill it.
Placement of Screws and Rods
The surgeon may implant screws and rods to provide additional support. Adding additional support to the spine can also be accomplished with bone grafts.
Post-Op Bone Fusion
A bone graft will form a connection between the vertebrae above and below as it grows through and around the implant. The process of fusing bones together is known as fusion.
What Happens After the TLIF surgery?
TLIF surgery usually requires a 3 to 5 day hospital stay. Pain medication is administered intravenously for the first few days to control pain.
Following surgery, a physical therapist helps the patient start a walking program. A physical therapist will assist the patient in getting into and out of bed. A walker and back brace may also be recommended by the doctor.
It usually takes two days after surgery to remove the surgical drain. Upon discharge, patients are prescribed oral narcotic painkillers.
TLIF Can Help Relieve Leg and Back Pain
TLIF is a common spinal procedure and can be quite effective in treating low back pain. However, not all people are suitable candidates for surgery. If more conservative treatments have failed and TLIF surgery has been recommended to you, Dr. Butler is an extremely qualified and experienced surgeon with over 20 years of experience. To schedule an appointment, complete our contact form.
