Lumbar – Transforaminal Lumbar Interbody Fusion (TLIF)

TLIF  – Transforaminal Lumbar Discectomy (with Interbody Fusion) 

Many of the symptoms associated with pinched nerves or spinal pain are due to herniated discs, bulging discs, or otherwised damaged discs. While many of these problems can be addressed through conservative therapy, spinal adjustments, decompression therapies or minimally invasive techniques, degenerated or collapsed discs may need to be removed in a procedure known as a discectomy.

Let’s take a look at one of these procedures — a transforaminal lumbar discectomy with interbody fusion, or TLIF.

Chronic back pain can be debilitating. When conservative treatments have failed there are new surgical options for curing the problem. The term fusion is commonly used in discussing spinal treatments. Minimally-invasive fusion is a particular method of treatment that surgeons at NYC Surgical have been practicing for years successfully. Most fusions performed by other spine surgeons require a couple days of hospitalization. Furthermore, recovery time can take 6 months up to a full year.

At NYC Surgical, we have developed and refined a technique that allows for outpatient fusions to be performed on a regular and consistent basis. These are done through a small incision, typically 1-inch in size, and generally do not require cutting muscle. This allows for a relatively bloodless surgery with less post operative pain, which means our patients go home the very same day.

Pain relief from spinal compression

Some forms of spinal pain involve a disc that is not herniated or bulging, but severely compressed or deteriorated. The intervertebral discs are composed of a gelatinous inner material encased in cartilage. They play a critical role in cushioning the spine against thousands of shocks every day. A variety of incidents and conditions can cause these components to stop doing their job properly which can cause pain and/or other symptoms.

A herniated disc, for example, has a weakness in its casing that causes part of the inner material to bulge outward, where it can pinch nerves and create pain, numbness, muscle atrophy and other debilitating problems. Discs also flatten out with age, losing their water content and allowing for increasing spinal compression and resulting pain. This can result in a condition called spondylysis in which the vertebral bones themselves pinch the nerve roots. Fortunately, the TLIF procedures performed at NYC Surgical can provide a more permanent relief from these and other related conditions.

Who qualifies for TLIF surgery?

TLIshould be considered only after conservative methods such as pain relievers, corticosteroid injections, physical therapy and exercise have been tried and found wanting. In fact, other surgeries such as microdiscectomyshould probably be pursued as a minimally invasive course of action to correct problems involving herniated discs and spinal compression. However, herniations that recur after a microdiscectomy may require TLIF for long-term spinal stabilization. People suffering from the effects of damaged or flattened discs who cannot expect a reversal or healing of the condition may have an immediate need for this procedure as well. The severity of the symptoms can also impact the surgeon’s decision to recommend TLIF. We perform these fusions, so minimally invasive, that most individuals qualify for this method even if they suffer from asthma, diabetes and/or obesity.

Process for interbody fusion

“Interbody” refers to the introduction of an organic or inorganic spacer to replace the disc in the spinal column. This has the effect of arresting motion at that joint, but it also relieves nerve pain by maintaining a constant, correct space between two vertebrae. There are different ways to approach an interbody fusion. A transforaminal fusion approaches from the side of the trouble site, as opposed to approaching from the rear (posterior fusion) or the front (anterior fusion).

A transforaminal fusion or TLIF is generally a specialized approach to the lumbar disc. Our minimally invasive approach is done using a microscope, so it is maximally safe. We place the same bone graft in a small incision as other spine surgeons do through a much larger incision. Our techniques save muscle from being cut or otherwise damaged. Since the muscle doesn’t bleed, the patient isn’t as sore when they wake up which leads to a faster recovery and less down time. Most of our patients are much improved in a week.

Advantages of our TLIF approach

Most fusion surgeries utilize some sort of fixation.  Screws are commonly used to help hold the fusion while the bone heals. These components are also placed by the doctor in a minimally invasive fashion. Plus, all of our minimally invasive techniques have successfully been performed on an outpatient basis which we believe has helped keep our infection rate to a minimum. Surgeries done in an open fashion, or with larger blood losses, or at a hospital, tend to have a much higher infection rate statistically.

To learn more about this surgery or to discuss other options, contact our Neurosurgery and Spine team at NYC Surgical Associates, where we are happy to discuss this and any other options that may pertain to your care. You may contact us at 888-286-6600 or by submitting our online contact form.