Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Hip bones too high for TLIF?

DIFerrisDDIFerris Posts: 86
edited 06/11/2012 - 8:32 AM in Back Surgery and Neck Surgery
Hi all,

When I had the consultation with the 2 NS's that will be doing my fusion, I was told that a TLIF was not an option as my hip bones were too high and there would no access available from the side.

I know I have always had issues finding clothes to fit me properly - I have long legs and a short body - but I never realized it was a physical limitation! =)) An "I told you so" comes to mind for my mother, but alas, that helps nothing at this point :?

Now I am wondering if this contributed to my spine problems. I am one of those people that actually cannot say what I did to hurt my back. I just woke up one night in agonizing pain, and that started this journey for me!

Has anyone else been told this? I didn't think to pose any questions to the NS at the time as I was just concentrating on hearing how the procedure was going to be performed.



  • Sorry you wont be able to have it done as ou wanted. I had PLIF in Dec on 2 levels. I also am unsure of how my discs got torn and just started hurting one day. Good Luck on your upcoming surgery. I will be thinking of you and saying a prayer that everything works out well. Know that I am with you as you recover..Sending a great big Hug! >:D< >:D< >:D<
  • Hi, I had an XLIF (fusion from the side) last year. I barely squeaked by that hip bone height requirement. If they are fusing lower lumbar verts, they need room to get the long equipment through the psoas muscle, over the hip bone, and into the vertebral space. Too low, and the equipment won't be able to skim over the hip bone ridge. I had just enough room at L4-L5. Anything lower, and he couldn't have done it. My body was normal, it was just logistics. So I don't know if that is what happened in your case, but it may explain things. Good luck. KE
  • Wait, what???? :O I, myself have the long leg/short body syndrome, and I had a tlif, but they went in from the back only, using two 2-inch incisions just over the L5/S1 area, and two little tiny pokey incisions just above the "crack" =)) Maybe, find yourself another surgeon that has experience with this type of TLIF?

    Good luck!

  • This is something that can be a common problem for women having TLIFs. Our hips were made different than men because we have to carry babies. In fact, complications can arise from women having TLIFs because of the angle needed for the instruments sometimes make the surgeon use smaller cages than should be used and can cause postop complications. Most people I've seen post didn't stay any shorter time in the hospital with a TLIF than a midline open fusion. It sounds really good when you hear about it, but women are different and you've got 2 opinions from doctors who see you saying no.

    Don't have your heart set on a TLIF. The studies I've read show no difference in the two year outcomes of TLIF versus traditional midline fusions. In fact, often the surgeon is better able to visualize things with the midline incision than a TLIF. Yeah, TLIF sounds good, but if doc is in there a long time cleaning stuff up the retractors that they use can deprive muscle tissue of oxygen resulting in more muscle damage than if they had just cut them in the first place.

    I had a two level TLIF, sure wish I had a traditional midline fusion. Of course, this is my own story and my own research and what my docs have said, it could be very different for you. But you have 2 opinions telling you no TLIF.
  • I didn't even thing about the childbirth angle. That makes sense.

    I have known since that meeting that it would be a PLIF, and I am okay with it. I just happened to think of that today and wondered if anyone else had run into this.

    I don't see the advantage if, like you say, the recovery is pretty much the same. My NS also said that it was easier on the patient to do the TLIF as it is minimally invasive.

    I just want to be fixed, so front, side, back... I don't care! :)

    Thanks again for your support!

    You guys are the best! >:D<

  • I'm still confused... my TLIF was all from the BACK, how can your hips be in the way???? :??
  • Whyme said:
    I'm still confused... my TLIF was all from the BACK, how can your hips be in the way???? :??
    Sorry, I may not have referred to it correctly. I was talking about the procedure where they go in from the side. I thought that was what it was. I am still learning about all this! :/

  • Yeah, the TLIF is in the back. But because of the instruments they use and "trying" to do it minimally invasive, the angle at which the surgical instruments have to be inserted can be blocked by our hipbones(like, if hipbones large or high, they can't move the instruments externally to get the right angle because bone and not soft tissue is in the way.) This is not the right example, but best I can think of: if you were using a lever under a boulder to move it, but something was under the top of the lever so you couldn't push the lever down to the ground, you couldn't move the boulder as well. This is not the right example, but I don't know how else to say that the hip bones can prevent the right angle to do the job. Does this help at all????
  • Thank you for the clarification. I am not well versed on these subjects (hopefully I never will be... I work on computers... LOL), and I don't always get out what I am thinking.
  • The argument for minimally invasive procedures is that they don't have to cut the major muscles to expose what they need to work on. It makes that part of the patient's recovery easier and provides an excuse to get the patient out of the hospital faster so the insurance companies like it. But, as ernurse pointed out, there can be other problems associated with the surgery.

    Do you have your house prepared for your return after surgery? I highly recommend a satin bottom sheet for the bed, a raised toilet seat and a "grabber" if you don't have them already. Put out all the stuff you will use often at counter height so you are not tempted to bend after surgery. Before you know it, you will be back home and on the board asking questions about recovery!!

    Good luck and keep us posted.
    xx Gwennie
  • I think I have gotten most of what I will need for early days of recovery at home. I read all the posts in the recovery tips. Kudos to everyone who took the time to post those. Those like me would never have thought to get most of those things.

    I am anxious now to get this over with. I know it will be hard at first, but I am so tired of the horrible pain I get shooting down my leg if I step wrong or twist a little too much one way.

Sign In or Register to comment.