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Another stupid question - TLIF

JoyJJoy Posts: 560
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
Sorry to be so dense here, but gonna ask anyway. When you have TLIF surgery, do they cut the muscles in the back or just move them around?
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Comments

  • Wow - not a stupid question at all! I just assumed they did not cut the muscles but really don't know! A good thing to find out. Thanks for thinking of that.
  • but do not know for sure, that the approach was the same, via the back but then they approach the bone from side on rather than straight.

    urious.. :?
  • Definitely not a stupid question. I think I read somewhere that some will cut through the muscle while another will move slower and separate the muscles. I would think that you could heal faster and be in less pain if they were to just separate the muscles.
  • The muscle is slowly moved via dilator, and the a small amount of retraction (pulling them back from the bone) is done as well. It is supposedly the option with the least amount of muscle involvement. I hope so! I am having one on the 21st.

    One Love,

    Stephanie
  • MY muscles were cut (per OR report) and they were stiched back together with disolvable stiches.
  • I did a little google search and it appears that there are a couple different operations. Some cut some don't. Mine did. I think that if the process is removed then some muscles are cut.
  • I don't know all the details about my TLIF/laminectomy, but what everyone else wrote here makes sense. The nerve was my biggest worry because it is so delicate, and I have had consistent sciatica since my first discectomy . Some doctors will hire a Neurodiagnostic company to monitor your central nervous system and peripheral nerves during surgery for additional safety.
    There is a lot involved in this because it is major surgery. You'll find a wealth of experiences here, but it is a good idea to ask your surgeon because he can explain it in detail. Even though a lot of people have the same surgery, each case is different.
  • I'm amazed at how this depends on the surgeon. I guess I'll have to call my good looking doc and ask whether he did or not. Thanks, again, to all my friends here on SP with such good info.
  • I am having a minimally invasive TLIF done December 3 and I was specifically told they would not be cutting my muscle. My incision will be about 1.5 inches and then they will use dialators to gradually widen the opening and move things aside.

    How big was your incision? I would guess that if you also had a small incision that your muscles weren't cut, but the only one who can tell you for sure is your surgeon's office.
  • Yes, muscles have to be cut during a TLIF. The incisions are supposed to be smaller than a traditional open approach because instruments are used to slowly widen the incisions without more cutting. I'm sorry, I can't remember the study I read so can't quote my source, but while TLIF gained a lot of popularity(sure does sound good), 2 year outcomes were similar to those with open approaches. The whole minimally invasive thing really sold me(I had a two level TLIF 6/07) but then found out in the long run patients' outcomes really weren't any different.

    One possible complication-if your doc is not experienced with this, there have been issues with retractors being left in place too long and causing damage to those muscles that are "supposed" to be just stretched instead of cut.

    Most important learning point is to always get more than one opinion from qualified surgeons.
  • I had three-level fusion with no post-operative pain. I was surprised, as I read here that one thing that really painful is that they cut through the various muscle layers. So I asked my surgeon, and he said that he only cut through the skin and fat, and then stripped away the muscles but only as far as was necessary for him to access the spine. He also said that some surgeons move the muscles way back (I guess it is easier for them) and when that heals it is quite painful. So talk to your surgeon and ask him what he plans to do and why.

    Good luck,

    Kin
  • Wow... A 2 level fusion with only a 1.5 inch incision? That's awesome. I only had a one level fusion but I had a 6 inch incision on my stomach, and two 1 inch vertical incisions on my back, and two 3 inch diagonal incisions beneath those.
  • Hi Joy, no question is stupid. As the others have pretty much summed up, it depends on the surgeon. There is open TLIF which has the same incision as PLIF, just access to the disc space is the difference. Then there is minimally invasive using the dialators through a very small incision. Some surgeons cut the muscles, some just spread them apart. Mine were cut as I had my spinous processes removed as well as lamina and facet joints from L4 and I think L5 also. If you want it, you can get your op report from the hospital. You have to sign a release and they might charge a copy fee, or just ask your cute surgeon. >:D< Cali-Sue

    P.S. I have good links for videos for both if you want to watch.

    http://www.or-live.com/genesishealth/1677/

    http://www.or-live.com/memorialhermann/1281/index.cfm?r=orlive

  • anjuan said:
    I am having a minimally invasive TLIF done December 3 and I was specifically told they would not be cutting my muscle. My incision will be about 1.5 inches and then they will use dialators to gradually widen the opening and move things aside.

    How big was your incision? I would guess that if you also had a small incision that your muscles weren't cut, but the only one who can tell you for sure is your surgeon's office.
    What she said. ;)
  • Cali-Sue...that video is awesome! Thanks so much for the link. Incredible!
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