Spinal fusion (such as a TLIF) is a surgical technique to stabilize the spinal vertebra and the disc or shock absorber between the vertebra. Lumbar fusion surgery is designed to create solid bone between the adjoining vertebra, eliminating any movement between the bones. The goal of the surgery is to reduce pain and nerve irritation.
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Spinal fusion may be recommended for conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations. Surgeons perform lumbar fusion using several techniques. This article describes the transforaminal lumbar interbody fusion (TLIF) fusion technique.
Surgical hardware is applied to the spine to help enhance the fusion rate. Pedicle screws and rods are attached to the back of the vertebra and an interbody fusion spacer is inserted into the disc space from one side of the spine.
Bone graft is placed into the interbody space and alongside the back of the vertebra to be fused. Bone graft is obtained from the patient’s pelvis, although bone graft substitutes are also sometimes used.
As the bone graft heals, it fuses the vertebra above and below and forms one long bone.
TLIF fuses the anterior (front) and posterior (back) columns of the spine through a single posterior approach.
The anterior portion of the spine is stabilized by the bone graft and interbody spacer.
The posterior column is locked in place with pedicle screws, rods, and bone graft.
Bone fusion is enhanced because bone graft is placed both along the gutters of the spine posteriorly but also in the disc space.
A spacer is inserted into the disc space helping to restore normal height and opening up nerve foramina to take pressure off the nerve roots.
A TLIF procedure allows the surgeon to insert bone graft and spacer into the disc space from a unilateral approach laterally without having to forcefully retract the nerve roots as much, which may reduce injury and scarring around the nerve roots when compared to a PLIF procedure.
As with all forms of lumbar spine fusion, prior to TLIF surgery medical clearance is obtained. Smoking should be stopped. Patients may require pre-donation of blood to be used at the time of surgery.
