Trans-Foraminal Lumbar

Interbody Fusion

Procedure Description

Trans-foraminal lumbar interbody fusion is a surgical operation that involves putting implants (also recognized as a cage or space) in between lumbar vertebral segments with bone graft to attain fusion of the vertebrae. This procedure is usually referred to simply as “lumbar fusion” or “lumbar stabilization”. In addition to the implant between the vertebral segments, typically the surgeon will want additional hardware (rods and screws) to more stabilize and optimize for successful fusion. The implant placement between vertebrae aims to restore correct height in between the vertebral segments and thereby decompress the spinal and foraminal canals.

TLIF can be performed through open or minimally invasive approaches. often times once a TLIF is performed through a minimally invasive approach it’s referred to as a minimally invasive stabilization (MIS). whether or not TLIF is performed through an open or minimally invasive approach is decided by a variety of things. These factors are principally associated with a patient’s condition and the ability of the surgeon.

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When to Consider

As with any spine surgery, a TLIF should solely be thought-about when the patient has failed conservative care and symptoms have persisted or worsened. In some cases, based on the severity of the pathology and also the associated symptoms, a TLIF is also considered before conservative care.

Symptoms you may be experiencing that would indicate a TLIF may be necessary, weakness and/or atrophy of the lower extremities, divergent pain, wrapping pain on the belt line, pain that’s localized to the lower back, numbness and/or tingling of lower extremities.

While a trans-foraminal lumbar interbody fusion can be accomplished through a minimally invasive approach, it’s vitally important that a patient set up for an acceptable amount for time to recover. Length of your time spent in recovery can vary depending on a number of things and return to work (in necessary) will vary. whereas recovery from a minimally invasive procedure can usually involve way less post-operative pain than recovery from an open procedure, with fusion surgery is paramount that a patient play close attention to post-operation restrictions and guidelines therefore as to not compromise the outside of the procedure.

What to expect in surgery

If your conditions are often treated through MIS/TLIF it’s possible that you will have the procedure done in an outpatient setting. This procedure usually takes between 90-150 minutes.

In order to accomplish a fusion, bone graft most of the time is harvested from the patients’ iliac crest (hip bone) and once this is done the graft is considered autograft. In alternative cases, donor graft is also used and this is often referred to as allograft. there also are alternative synthetic forms of graft that may be used on a case by case basis. Autograft, however, is considered the gold standard in achieving fusion.

Hardware (screws and rods) is usually placed during the procedure to act as scaffolding for the fusion to take place. several patients usually end up curious on how the hardware is placed in the surgeon doesn’t have direct visualization of the spinal anatomy. the solution is thru the utilization of intra-operative imaging. throughout the procedure, the operating surgeon will usually use fluoroscopic imaging as guidance for hardware placement.

The use of intra-operative imaging and minimally invasive approach for a TLIF procedure leads to considerably less trauma to the body, less blood loss throughout the procedure and usually less post-operative pain than that of an open TLIF. Again, whereas a patient could experience less post-operative pain it cannot be stressed enough to stick to the post-operative guidelines as they exist to ensure a positive outcome from the procedure.

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