Transforaminal Lumbar Interbody Fusion (TLIF) in Roseville, CA
Transforaminal lumbar interbody fusion (TLIF) is a spinal surgical procedure performed to provide relief from debilitating pain in the lumbar (lower) region of the spine. TLIF is performed with a posterior approach through the patient's back. A posterior approach can be advantageous since it avoids interfering with the many organs and major blood vessels present in the abdominal region. Interbody fusion involves removing an interverterbal disc, replacing it with a spacer and fusing the two vertebrae on either side of the spacer together. One of the advantages of the TLIF procedure is that it can be used to address pathology throughout the entire lumbar spine, as the surgeon is not limited by anatomical structures that sometime prohibit anterior and lateral approaches.
TLIF is a successful treatment for a number of lower back problems, such as spondylolisthesis and disc space collapse, also known as disc degeneration, that have not responded to more conservative therapies. Prior to the procedure, detailed images of the spine are produced using MRI and CT scans. In addition to confirming the diagnosis, these images allow the surgeon to pinpoint the exact location of the problem and to determine which implant device is most appropriate for use in the repair.
The TLIF Procedure
The TLIF procedure is performed with the patient under general anesthesia, positioned face down on the operating table. Depending on surgeon preference and technique, the procedure is usually accomplished through either a single midline incision or two incisions, each spaces about 5 centimeters to the side of the midline. Tools are used to separate and retract the muscles. An imaging device (fluoroscopy machine) is used to ensure that the precise vertebrae are targeted.
After dissection to the spine is completed, the lamina, which is the bone covering of the spine is removed and any excess bone is trimmed back to present an unobstructed view of the nerve roots and to ensure that the nerves are free of any compression. The injured disc and any debris are then removed. This recreates a space for the nerves that have been compressed, relieving pain and symptoms in the lower back and legs.
To fill the space that has been created, a cage (or spacer) is then inserted in the disc space. The cage is typically made of either titanium or plastic, and packed with bone graft. After insertion of the cage, screws and rods are inserted in the vertebrae to maintain stability of the spine around the cage. The spinal instrumentation secure the vertebrae in place, maintaining spinal stability as the vertebrae grow together and fuse.
Recovery from a TLIF Procedure
After undergoing a TLIF procedure, a patient typically remains in the hospital for 1 to 2 nights. A physical therapy regimen is started soon after to assist the patient in regaining strength and mobility. Certain activities are restricted during the recovery period, including heavy lifting, twisting the midsection, and bending at the waist. Many patients can return to work within a few weeks after the procedure if their employment does not require strenuous exertion. However, heavy lifting and manual labor are prohibited for 3-6 months after the procedure, depending on the extent of the surgery.