Transforaminal Lumbar Interbody Fusion (TLIF) Surgery

Transforaminal Lumbar Interbody Fusion (TLIF)

Home > Transforaminal Lumbar Interbody Fusion (TLIF)

Transforaminal Lumbar Interbody Fusion (TLIF) is a surgical procedure used to treat degenerative conditions of the lumbar spine, such as herniated discs, spinal stenosis, or spondylolisthesis, that cause chronic pain, instability, or nerve compression. The goal of TLIF is to stabilize the spine by fusing two or more vertebrae together, eliminating movement between them, and relieving pressure on the spinal nerves. This procedure is typically recommended when conservative treatments, such as physical therapy, medications, or injections, fail to provide lasting relief.

In a TLIF Procedure, the surgeon approaches the spine through a small incision in the patient’s back (posterior approach) and removes the damaged disc material between the affected vertebrae. This process creates space for an interbody fusion, which involves placing a bone graft or a synthetic spacer into the disc space. The bone graft promotes new bone growth between the vertebrae, eventually fusing them together over time. In addition to the graft, screws and rods are inserted to provide stability and ensure proper alignment while the fusion heals.

Indications for TLIF

Degenerative Disc Disease: Breakdown of the intervertebral discs leading to
pain and instability.
Herniated Discs: When a disc bulges or ruptures, compressing nearby
nerves.
Spinal Stenosis: Narrowing of the spinal canal that can put pressure on the
spinal cord and nerves.
Spondylolisthesis: A condition where one vertebra slips over another,
causing instability and pain.
Failed Conservative Treatments: Patients who have not found relief from
non-surgical treatments such as physical therapy, medication, or injections.

Diagnosis

Medical History: The physician gathers information about symptoms, their
duration, and previous treatments.
Physical Examination: Assessment of neurological function, strength, and
range of motion.
MRI (Magnetic Resonance Imaging): Provides detailed images of soft
tissues, helping identify disc herniations, nerve compression, and other issues.
CT scan: Sometimes used for more detailed imaging of bony structures.
X-rays: To evaluate spinal alignment and any bony abnormalities.

The TLIF Procedure

Anesthesia: The procedure is typically performed under general anesthesia.
Surgical Technique:
– Incision: A small incision is made in the lower back, usually on one side.
– Accessing the Spine: The surgeon carefully moves muscles and tissues
aside to access the affected vertebrae.
– Disc Removal: The damaged intervertebral disc is removed to alleviate
pressure on the nerves.
– Preparation of the Vertebrae: The endplates of the adjacent vertebrae are
prepared to receive the interbody spacer.
– Interbody Spacer Placement: A bone graft or interbody cage filled with
bone graft material is inserted into the disc space. This spacer helps maintain
height and encourages fusion.
– Fixation: The surgeon may use screws and rods to stabilize the spine further,
securing the vertebrae in place during the healing process.
– Closure: The incision is closed with sutures or staples, and a dressing is
applied.

Recovery

Initial Recovery: Patients typically stay in the hospital for 1 to 3 days. Pain
management and physical therapy may begin shortly after surgery.
Physical Therapy: Rehabilitation focuses on gradually restoring strength,
flexibility, and range of motion. A physical therapist will guide exercises to
promote healing and recovery.
Activity Restrictions: Patients are usually advised to avoid heavy lifting and
high-impact activities during the initial recovery period.
Follow-Up Visits: Regular follow-ups with the orthopedic or neurosurgeon are
crucial to monitor healing and adjust rehabilitation as necessary.

Risks and Considerations

Infection: There is a risk of infection at the incision site.
Blood Clots: Patients may be at risk for developing blood clots in the legs,
which can be managed with preventive measures.
Nerve Damage: Rarely, nerve injury can occur during surgery, potentially
leading to weakness or numbness.
Nonunion: In some cases, the vertebrae may not fuse properly, leading to
continued pain or instability.

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