Transforaminal Lumbar Interbody Fusion (TLIF)
What is it?
Transforaminal Lumbar Interbody Fusion (TLIF) is a specialized type of spinal fusion surgery used to treat various conditions affecting the lumbar region of the spine. This procedure is particularly employed for conditions that cause spinal instability, such as degenerative disc disease, spondylolisthesis (where one vertebra slips over another), spinal stenosis (narrowing of the spinal canal), or herniated discs.
TLIF is typically recommended for patients experiencing chronic back pain, instability, or neurological symptoms from lumbar spine conditions and who have not responded to conservative treatments like physical therapy or medication.
Recovery from TLIF involves a hospital stay and a period of rehabilitation. Physical therapy is often part of the recovery process, focusing on strengthening the back and improving flexibility. The fusion of the spine is a gradual process that can take several months. Patients are advised to avoid certain activities during this period to ensure successful healing.
Procedure
The unique aspect of TLIF is the transforaminal approach, where the surgeon accesses the spine from the back and side (posterior-lateral direction). This approach allows the surgeon to remove the intervertebral disc and place the bone graft with minimal disruption to the midline lower back muscles. The surgery involves the removal of the affected disc and replacing it with a bone graft or a synthetic cage in the empty disc space. This graft helps restore the proper height and alignment of the spine and, over time, fuses with the adjacent vertebrae to stabilize that segment of the spine. In addition to the bone graft or cage, the surgeon often uses rods and screws to immediately stabilize the spine and ensure proper alignment while the bone graft fuses.
The transforaminal approach causes less muscle and tissue disruption compared to traditional open surgeries, leading to less postoperative pain and quicker recovery.
By replacing the degenerated disc with a graft, TLIF restores the natural height of the disc space and improves spinal stability.