When it comes to spinal fusion surgeries, all types are definitely not alike. Case in point: TLIF surgery – a minimally invasive way to fuse together painful vertebrae so they heal into a single, solid bone – entails its own unique approach and purpose, helping many chronic back pain sufferers find lasting relief, according to Praveen Kadimcherla, MD, an orthopedic spine surgeon at Atlantic Spine Center.
TLIF is just one of several forms of minimally invasive spinal fusion surgery, also known as MIS fusion. But the terminology surrounding this surgery, how it’s done and what benefits it offers can seem confusing to those with spine problems that aren’t effectively treated with more conservative measures such as medication, rest or physical therapy, Dr. Kadimcherla says.
“While MIS fusion surgery has been commonplace since the 1990s, TLIF is among the most innovative newer approaches to back surgery available today for lower back pain,” adds Dr. Kadimcherla, who completed two spinal surgery fellowships and is a published author on spine disorders and treatment. Dr. Kadimcherla explains 5 points that are important to understand about TLIF:
What is TLIF?
TLIF is short for oblique lateral lumbar interbody fusion, offering both a name and a description of its technique. “It’s the angle taken when the surgeon gains access to the spine from a posterolateral view, which is the approach taken through a patient’s back and just to the side of the vertebrae,” Dr. Kadimcherla notes.
Who undergoes TLIF surgery?
This type of surgery, which stops vertebral bones in the spine from painfully “grinding” together, is typically advised for patients coping with ongoing lower back pain from a wide range of causes, including:
- Bulging discs
- Degenerative disc disease, a chain of events in the discs that occurs naturally as we age
- Disc tears – a painful crack or tear in the outer shell of a disc when it begins to toughen or dry up
- Failed back surgery, which occurs for a variety of reasons such as inaccurate diagnosis or improper healing
- Facet joint syndrome, which is degeneration and arthritic changes occurring in facet joints between vertebrae commonly caused by aging and wear-and-tear
- Foraminal stenosis, a narrowing of the spaces between vertebrae due to displaced bone or soft tissue
How is TLIF performed?
Like other MIS fusion procedures, TLIF is done with special tools known as tubular retractors, which are placed into a tiny incision and through soft tissues to the designated spot on the spine. But unlike other types of MIS fusion, TLIF surgery is approached through the patient’s back just to the side of the vertebrae. Since such a small incision is used, the surgeon doesn’t have to move, remove or alter major muscles, normal bone structures, or nerve bundles. At the area needing repair, the surgeon implants material such as a bone graft that maintains proper spacing of the vertebrae as the bones grow together. The entire procedure typically takes about 90 minutes or less.
What is recovery from TLIF like?
Because TLIF is both minimally invasive and minimally disruptive to tissues surrounding the spine, the procedure is usually done on an outpatient basis and recovery is swift. “Many patients are able to get up, walk around and return home within a few hours after surgery,” Dr. Kadimcherla says. “After the initial recovery, many patients benefit from a course of physical therapy to help their back muscles become stronger and more flexible.”
What are the advantages of TLIF?
The benefits of TLIF are compelling, Dr. Kadimcherla says, including minimal blood loss during surgery and a lower risk of needing a blood transfusion during this technique compared with traditional “open” spinal fusion surgery using a much longer incision. Additionally, TLIF patients typically need less pain medication after surgery.
“Many TLIF patients resume their normal recreational activities within weeks – not months or longer – because this procedure is so kind to surrounding tissues,” Dr. Kadimcherla says. “It offers remarkable results.”
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