TransforaminalInterbody Lumbar Fusion (TLIF)
Transforaminal = through the foramina, openings through which nerve roots exit the spine.
Interbody = between the vertebral bodies.
Lumbar = having to do with the spine in the lower back.
Fusion = a process in which bones “fuse,” or grow together into one bone.
What is an MIS TransforaminalInterbody Lumbar Fusion (TLIF)?
- A TransforaminalInterbody Lumbar Fusion treats spinal instability or weakness by permanently uniting bones of the lumbar (lower) spine.
- The goals of a TLIF are to decompress (remove the pressure from) the spinal cord and/or nerves, re-stabilize the spine, and prevent further movement and degeneration at the joints in question.
- A TransforaminalInterbody Lumbar Fusion is a particular type of fusion, or surgical procedure that permanently fuses, or unites, bones of the spine. The fusion is achieved using bone graft: bone material either acquired from a bone bank or transplanted from elsewhere in the patient’s own body. Over time, the bone graft and the bones of the spine grow together, forming one united bone.
- The openings called foramina, through which the nerve roots exit the spine, are enlarged. (Part of the surgery takes place through the enlarged foramina–hence the “transforaminal” portion of the procedure name.) This removal of bone and disc and enlargement of the foramina makes the TLIF more than just a fusion surgery. It’s also a decompression surgery–a surgery that can relieve pressure on the spinal cord or nerve roots.
- A TLIF may be performed usinga minimally invasive exposure that uses only very small incisions and minimizes disruption to the body’s tissues, often resulting in less postoperative pain and a shorter recovery
When is this Procedure Performed?
- TLIF can be performed for numerous spinal conditions, especiallydegenerative disc disease, herniated discs, or spondylolisthesis. These conditions may cause spinal cord or nerve root compression, spinal instability, and weakness. The TLIF procedure is performed to decompress (remove the pressure from) the spinal cord and/or nerves, re-stabilize the spine, and prevent further movement and degeneration at the joints in question.
How is this Procedure Performed?
- A TLIF is performed under general anesthesia, which means the patient is unconscious.
- Under C-arm/ Xray guidance pedicle screws are put percutaneous. The surgeon makes a small 2-2.5cm incision in the lower back over the bones of the spine.
- The surgeon then uses specialized instruments to free/ decompress the trapped/pinched nerve and remove a portion of the intervertebral disc between the vertebral bodies. The surgeon places a spacer/ Cage (a supportive device) between the vertebral bodies, where the disc once was. The spacer holds the vertebrae the proper distance apart, just as the disc once did.
- Instruments such as the cage, screws, and rods are intended to provide short-term stability to the spinal column. Good bony fusion provides long-term stability.
How long will I stay in the hospital?
- On average, patients are discharged three to five days after the surgical procedure.
Will I need to take any special medications?
- Patients may be prescribed pain medications to help manage pain.
Will I need to wear a brace?
- Rods and screws provide internal stability. Plain LS belt would be required that too while walking and travelling.
When can I resume exercise?
- Patients are usually encouraged to increase their activities as they are able to tolerate.
Will I need rehabilitation or physical therapy?
- The Primary rehabilitation is walking for the initial one month post surgery which begins from the next day of surgery.
When will I return for follow-up with my surgeon?
- The surgeon typically schedules a follow-up visit 10-12 days after surgery for wound check and then after 3 months.