Transforaminal Lumbar Interbody Fusion – Relief for Back and Leg Pain
Transforaminal lumbar interbody fusion, or TLIF, is a procedure used to remove a portion of a disc that is causing back or leg pain. Similar to the posterior lumbar interbody fusion, or PLIF procedure, the spinal vertebrae are fused using a bone graft after the offending disc has been removed. The difference between procedures is that the TLIF procedure places a single bone graft between the vertebrae on the side, while PLIF places two bone grafts from the rear. Transforaminal lumbar interbody fusion inserts the graft from the side in the area that the facet joint has been removed in order to avoid damaging or moving nerve roots.
Transforaminal Lumbar Interbody Fusion Procedure Specifics
In the middle of the low back an incision is made so the surgical team can remove the entire facet joint along one side of the spine to provide access to the affected disc. In order to remove most of the intervertebral disc a grasping instrument is used. The removal of the disc as well as the facet joint is what relieves the pressure on the compressed spinal nerve that is causing back or leg pain and what allows it to return to its proper positioning.
Following the removal of the degenerated disc, a single bone graft is inserted in the side in the area that was exposed through the removal of the facet joint. The bone graft fuses with the vertebrae below and above where the affected disc was located to provide stability to the spine.
End of Procedure
In some variations of transforaminal lumbar interbody fusion, spacers may also be inserted into the disc space to aid the process of fusion.
Following the insertion of the bone graft as well as potentially the insertion of spacers, the incisions are closed and dressed. This completes the procedure. Patients are generally kept in the hospital for two to four days afterwards, and may or may not require a post-operative brace. To aid in the healing process, patients are asked to avoid bending, turning, twisting and heavy lifting for six to twelve weeks.