What is transforaminal lumbar interbody fusion (TLIF)?
Transforaminal lumbar interbody fusion, or TLIF, is a type of posterior spinal fusion procedure used to join 2 or more vertebrae in the lumbar region of the spine to relieve pressure on the spinal nerves/cord and to stabilize the spine. Posterior just means that the surgeon approaches the spine from the back, making an incision in the middle of the back that also lines up with the affected vertebrae.
When should TLIF be recommended as a treatment option?
TLIF may be recommended for those suffering from severe lower back or leg pain that non-surgical treatment cannot fix. Most of the time these patient’s symptoms can be associated with the following spinal conditions:
- Degenerative disc disease
- Herniated disc
- Spondylolisthesis (vertebra slipping forward over vertebra below it)
- Spinal stenosis (narrowing of the spine)
How is the TLIF procedure performed?
- After anesthesia is administered to the patient, an incision is made in the middle of the patient’s back over the affected vertebrae
- Muscles and soft tissues are carefully retracted to gain access to the spine
- X-ray is used to confirm the vertebral levels
- The lamina and facets (joints) are removed
- Scrapers and other tools are used to remove the disc between the vertebra, followed by insertion of bone graft and a specialized cage (spacer) inside the space created between the adjacent vertebrae
- Rods are then affixed to connect the screws and to stabilize the spine
- After that, the muscles and soft tissues are put back to where they were and the incision is closed
As healing occurs after the procedure, the bone graft fuses with the spine. This stimulates growth of a solid mass of bone which helps in stabilizing the spine.
What does postoperative recovery look like?
Many patients notice early improvements of their symptoms, while others may notice improvements more gradually over time. You may experience discomfort, pain at the incision site, and muscle spasms in the back. Care is taken to try to provide and adjust pain medications to help with these symptoms.
The duration of your hospital stay will vary depending on your recovery. If needed, a brace and pain meds may be prescribed upon discharge to help alleviate discomfort. Although we typically encourage early mobilization, it is best to avoid rigorous activities, heavy lifting, and aggressive bending and twisting while recovering and while the bone is healing.
Smoking and using NSAID’s for pain relief should be avoided as these can interfere with the bone healing and fusion process. We recommend you strictly follow the post-operative instructions given to you by your surgeon to promote healing, reduce possibility of complications, and to facilitate getting back to doing the things you love in life.
What are the risks and complications?
As for all surgical procedures, risks and complications may happen. Some of these include:
- Infection
- Need for blood transfusion
- Blood clots or blood loss
- Nerve/spinal cord damage
- Bowel and bladder problems
- Adverse reactions to anesthesia
- Failure to fuse
- Failure of instrumentation
- Need for future surgery
- Durotomy (opening of the spinal fluid sac)
The underlying risk of any spinal fusion procedure is failure of the vertebral bone and bone graft to fuse together, which may require an additional surgery.
Educate yourself and make an informed decision with the help of medical professionals. If you have any questions, comments, or concerns pertaining to TLIF and if it’s right for you, talk to your surgeon or contact us to set up an appointment.