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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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.