Transforaminal Lumbar Interbody Fusion (TLIF)
A Transforaminal lumbar interbody fusion (TLIF) is a surgical technique that corrects a variety of spinal conditions, such as disc herniation, degenerative disc disease, and spondylolisthesis. The procedure stabilizes the vertebra to eliminate movement in a spinal segment. When the discs, or pads, between the vertebra, are bulging or deteriorating, back and leg pain can occur as a result of nerve irritation. In essence, the spine is unstable. Fusion surgery creates a solid bone between neighbouring vertebrae and eliminates abnormal movement between them.
How is a TLIF performed?
The vertebrae are accessed through the hollow bony openings (foramina – openings allowing the nerve to exit the spinal cord) between adjacent spinal segments. The damaged disc is partially removed so that a spacer/cage can be inserted into the disc space. A bone graft is inserted into the spacer/cage to create a stable disc that results in permanent fusion and stability of the spine. The spine becomes one long bone, depending on the number of vertebrae involved. The front, or anterior, part of the spine is fused with the bone graft in the disc space, while screws, rods, and bone grafts are used for the posterior aspect of the spine nearest the surface of the back.
The advantage of TLIF, over other types of spinal fusions, is that both the disc space and lateral aspects of the spine are stabilized. The spacer/cage insertion allows for height to be maintained, and it takes pressure off the nerves that come off the spine (roots). Because the approach is on one side and not two, nerves and muscles are not traumatized, or moved. Less injury, scarring, and bleeding are the improved outcomes compared to other techniques, such as the open technique involving a long, back incision.
Scaring, tissue damage and recovery time are minimized
Even with great advancements in medical technology, surgery still carries risks, and these should be discussed with your surgeon. Risks can be reduced by following the surgeon’s instructions, both before and after surgery, and with the assistance of your primary care practitioner at home.
With any spinal fusion, there is an increased risk of future ‘adjacent segment disease’. Adjacent segment disease is a result of stress and strain on adjacent spinal levels and can sometimes result in a need for further surgery. Concerned patients often prefer to be assessed for a motion-preserving solution, such as Artificial Disc Replacement (ADR) or Total Facet Joint Replacement, however, sometimes a spinal fusion is the necessary and required solution.