What Is Transforaminal Lumbar Interbody Fusion (TLIF)?
It’s a mouthful: transforaminal lumbar interbody fusion, or TLIF procedure for short, is a contemporary approach to spinal fusion surgery of the lower back. During this procedure, a spinal surgeon like the renowned Dr. Branko Skovrlj removes an intervertebral disc in a procedure called a discectomy and joins two or more of your spinal bones, using hardware to replace what’s extracted. The goal of TLIF surgery is to:
- Decompress the spinal cord and the root nerves that exit the spinal cord
- Re-stabilize the spine by replacing a damaged intervertebral disc and fusing two vertebrae together as one bone
- Prevent further movement of the affected vertebrae joints to relieve pain and prevent further damage
- Stop further degeneration at the affected joints
This is a complex surgical procedure that must be performed by a highly experienced neurosurgeon. Dr. Skovrlj is an accomplished neurosurgeon, one of the few in the country to focus on the complexities of spine health. He founded NU-Spine: The Minimally Invasive Spine Surgery Institute in Edison, New Jersey.
He’s an expert in state-of-the-art spinal procedures, including:
- TLIF procedure
- Posterior cervical discectomy
- Spinal fusion surgery
- Many other minimally invasive spine surgeries
How Do I Know if I Need TLIF Back Surgery?
Your spine doctor first has to determine the underlying cause of your lower back pain. He gives you a physical exam and takes your medical history. If necessary, he orders comprehensive tests to determine a diagnosis. At NU-Spine, Dr. Skovrlj has access to the latest spinal diagnostic and treatment tools.
If your doctor determines that surgery can help you, your spinal doctor may try conservative measures first. Even if you’re a candidate for TLIF surgery, surgery always comes as a last resort, when other treatments have failed. But those non-surgical options have to be tested first. They may include:
- Activity modification
- Pain medications
- Nerve sheath injections
- Physical therapy
When Is TLIF Spine Surgery Unavoidable?
If spine surgery proves necessary, it means all the conservative treatments haven’t succeeded in alleviating your pain. Minimally invasive Transforaminal Lumbar Interbody Fusion lumbar fusion becomes necessary if:
- Previous treatments, including other spinal surgeries, hasn’t worked.
- You’re diagnosed with a slipped disc.
- You’re experiencing significant back pain caused by a defective or herniated disc.
- You have instability in your spine.
- You’ve been diagnosed with lumbar stenosis
- You have facet joint pain.
- You’re suffering from degenerative disc disease or degenerative joint disease.
Dr. Skovrlj and his team at NU-Spine use minimally invasive surgery to treat a wide range of spinal disorders. No matter what your spinal diagnosis, he can find a long-term solution. He treats such complex spinal conditions as myelopathy, pars defect, and spondylosis.
What Happens During TLIF Surgery?
Transforaminal interbody lumbar fusion treats lower back problems by sacrificing some of your spine flexibility. The procedure entails permanently fusing the front and back of two vertebral bones through a posterior approach, meaning from the back.
For this spinal fusion to succeed, your spine surgeon uses a bone graft. Dr. Skovrlj either collects bone material from a hospital bone bank or transplants a bone from somewhere else on your body. Given enough healing time, the graft and the vertebrae form one united bone. The TLIF procedure process follows a series of steps that include:
- General anesthesia is administered; you’re unconscious during the entire procedure.
- If your doctor is using your own bone as a graft, that’s removed first, usually from your hip.
- A small incision is made over the target area of your spine.
- Your surgeon removes part of the facet joint and lamina.
- Skovrlj enlarges of the foramina openings, where nerve roots exit the spine, which serves to decompress your spinal cord and nerves.
- Next, all or part of the intervertebral disc is removed.
- Your surgeon inserts a spacer that replaces the removed disc. Often, the is spacer is a porous box filled with the graft material.
- Pedicle screws in the bones above and below the spacer stabilizes and begins to fuse the bones together.
- Finally, Dr. Skovrlj removes the instruments and closes the incision.
Is TLIF Fusion Reversible?
As the bone graft heals, it fuses the vertebra above and below and forms one long bone. The spacer containing the bone graft allows the bone material to grow through it. The growing bone fuses with the each of the adjacent vertebrae. So transforaminal lumbar interbody Fusion fusion is not reversible.
Your spine surgeon explains the procedure at the first consultation to put you at ease and help you make an informed decision. After the procedure, you can expect:
- Several days in a hospital before being released
- Temporary pain medication for any discomfort at the incision site
- Pain relief due to the decompression of your spinal cord
- Some stiffness
- Restrictions on your activities for a few weeks
- Physical therapy starting the day after surgery
- A follow-up visit with your surgeon to check your healing process