Transforaminal Lumbar Interbody Fusion (TLIF) Surgery

What is TLIF Surgery and Why is it Done?

Transforaminal Lumbar Interbody Fusion (TLIF) is a surgery to treat conditions in the lower back (lumbar spine) that cause pain, instability, or nerve compression. It’s commonly used for issues like degenerative disc disease, unstable spondylolisthesis (when one vertebra slips over another), or spinal stenosis (narrowing of the spinal canal) with spinal instability. These conditions can lead to lower back pain, leg pain, numbness, or weakness. TLIF removes a damaged disc, relieves pressure on nerves, and fuses two or more vertebrae together to stabilize the spine and reduce pain.

How is the Surgery Performed?

• Anesthesia: You’ll be under general anesthesia, so you’ll be asleep and feel no pain during the procedure. 
• Incision: The surgeon makes a medium-sized incision (typically 2-4 inches) in your lower back according to the affected level of the spine.
• Accessing the Spine: The surgeon approaches the spine from both sides by moving muscles aside without cutting them. Under X-ray guidance surgeon places so called “pedicular screws” in vertebraes.   
• Disc Removal and Decompression: Surgeon approaches damaged disc through the foramen (the natural opening where nerves exit the spine), gently moving muscles aside. The damaged disc is removed, and any bone or tissue pressing on nerves is cleared to relieve pain and pressure. 
• Fusion: A so-called “interbody spacer” is placed in the empty disc space to support the anterior aspect of the spine. Small rods are inserted to connect previously inserted pedicular screws to hold the vertebrae in place while the bones fuse together over time. The bone graft encourages new bone growth, creating a solid connection between the vertebrae. 
• Closing: The incision is closed with stitches, leaving a scar that often fades over time.

The surgery usually takes 2-3 hours, and patients typically stay in the hospital for 2 nights after surgery.

Benefits of TLIF Surgery

• Effective Pain Relief: TLIF can significantly reduce back and leg pain by stabilizing the spine and relieving nerve pressure. 
• Improved Stability: Fusing the vertebrae prevents abnormal movement, which can reduce pain and prevent further damage. 
• Long-Term Solution: The fusion creates a stable spine, offering lasting relief for many patients.

Possible Risks and Complications

While TLIF is generally safe, all surgeries carry some risks, including: 

• Nerve Irritation: Nerves may be affected, causing temporary numbness, tingling, or weakness in the legs. 
• Dural Tear: The protective covering around the spinal cord may tear, but this can often be repaired during surgery. 
• Adjacent Segment Degeneration: The fused area may put extra stress on nearby vertebrae (adjacent level disease), potentially causing wear over time (3-5 years). 
• General Surgery Risks: These include infection, bleeding, blood clots, or reactions to anesthesia.

Following your surgeon’s pre- and post-surgery instructions can help reduce these risks. Be sure to discuss all potential risks with your surgeon to understand what to expect.

Who is a Candidate for TLIF Surgery?

You may be a candidate if you have conditions like degenerative disc disease,  unstable spondylolisthesis, or spinal stenosis with instability causing significant lower back pain, leg pain, numbness, or weakness that hasn’t improved with non-surgical treatments. Your surgeon will evaluate your condition.