Transforaminal Lumbar Interbody Fusion (TLIF)

A transforaminal lumbar interbody fusion (TLIF) is very similar to a posterior lumbar interbody fusion (PLIF) procedure. It can be used for any condition that requires a disc to be removed from between two vertebrae and the vertebrae to be fused. This includes serious spondylolisthesis, nerve compression and degenerative disc disease.

The primary difference between a TLIF and PLIF is that the entire facet of the joint is removed in a transforaminal lumbar interbody fusion procedure to create additional room for expansion. In a PLIF, only a portion of each of the paired facet joints is removed.

Since there is more space available, your surgeon can achieve better spine alignment using a larger implant or bone graft.

What is involved in the TLIF procedure?

In many cases the procedure can be conducted using minimally invasive surgical techniques. This greatly reduces damage to the muscle and skin since the incision is relatively small. It can also reduce the level of blood loss and post-operative pain.

Using an x-ray fluoroscope to view the operating environment, your surgeon will use a guide wire to install increasingly larger dilators over the location where the fusion is to take place.  A tube is placed over the dilator and the dilators removed. Instruments are used inside this tube to remove disc material so there is space for a bone implant or a fusion cage. Once the area is cleared, the cage or implant is inserted and stabilized with screws. Eventually, the two vertebrae will grow together and fuse, becoming one.

What can I expect after surgery?

The success rate of TLIF in terms of fusion taking place is between 90% and 95%. Several factors can affect fusion, including smoking and obesity. There is a small chance of infection or bleeding, but it is comparable to any surgical procedure and fairly uncommon.

A TLIF procedure will usually require a hospital stay of three to five days. Your doctor will want to make sure that your healing is progressing as planned and that there are not unexpected issues with the fusion.

You’ll be able to start walking again the day after your surgery. Your doctor will usually have a physical therapist visit you so you can get back on your feet safely. Pain medication can reduce your discomfort as you begin to heal. The pain should subside after a few weeks. This includes any pain from a graft taken from your pelvis or hip region. You may still have pain in your legs after surgery because some nerves may have been jostled around during the TLIF procedure. This should go away with time.

Your doctor will recommend that you limit your activities for a few weeks following surgery. This means you should avoid driving, shopping and even cooking. You want to allow your body to heal naturally and these activities can slow your progress. In most cases, you’ll be back to normal in four to six months after surgery.

Your doctor at the Celebration Health Spine Center will be happy to discuss the procedure in greater detail and answer your questions regarding TLIF.