Transforaminal lumbar interbody fusion, or TLIF, is a surgical procedure to fuse vertebrae together. Since the procedure creates a solid, inflexible bone “bridge,” the patient will be unable to bend his back at the spot where the fusion is performed. TLIF back surgery is frequently used to treat herniated discs that recur repeatedly, degenerative disc disease, spondylolysis or other conditions in which the patient’s pain level might be reduced by the stabilization.
TLIF is open surgery requiring a hospital stay of three to five days. The patient will normally begin physical therapy within 24 hours of the surgery, but initial activity will be limited. Many patients must wear a brace for all or part of their recovery. After discharge, patients will receive pain medications to take at home and will be restricted to light activities. Office workers can normally return to work in one to two months. Those whose jobs are more physically demanding typically have a longer recovery time before they can resume their normal occupations.
TLIF fuses both the posterior and anterior of the spinal column. The surgeon uses hardware and bone, if needed, to lock the posterior into place. The bone graft and spacer stabilize the anterior region.
To perform a TLIF back surgery, the surgeon will make an incision in the back to expose the spine. The disc between the two operative vertebrae is removed. The surgeon will harvest a bone graft from the patient’s hip and insert it in a cage or spacer that is inserted in the gap left by the disc he removed. He will also add bone to the sides of the disc space and the vertebrae. Plates or rods are screwed into place and the incision is closed.
Patients who have disabling leg and back pain and have failed all nonsurgical options may obtain significant pain relief from a TLIF. Studies report that 60 to 70 percent of patients undergoing the procedure indicated they experienced an improvement in their level of pain.
While TLIF normally results in reduced pain levels and solid fusion of the bone, rare complications can occur. As is true with any surgery, patients are at risk for complications from the anesthesia, excessive bleeding, damage to the nerves and infection. Patients may also develop blood clots, pneumonia, experience a stroke, or suffer a heart attack. Risks specific to the TLIF procedure include the possibility that fusion fails to occur, requiring another operation. The procedure may not alleviate the patient’s pain, and in a few rare cases, patients report their pain levels actually increased.