Transforaminal Lumbar Interbody Fusion

Minimally Invasive – Transforaminal lumbar interbody fusion (MI-TLIF) is a surgical procedure that joins two segments of the spine together through a posterior approach involving two small one inch incision.  The procedure is designed to stabilize the spinal vertebrae and replace the disc or shock absorber between them.  Typically, this is done in conjunction with a decompression procedure where disc, bone or ligament is shaved down to release the pressure on a patient’s nerves.  The procedure can be performed in a minimally invasive way, allowing for less muscle and soft tissue damage, less pain post-operatively, and a quicker recovery.  This can be performed in the hospital or in a surgery center. 

Here are some of the primary indications for the TLIF procedure:

1. Degenerative Disc Disease: This is a condition where the intervertebral discs lose hydration and elasticity, often leading to chronic pain. If conservative treatments fail, a MI-TLIF may be an option.
2. Spondylolisthesis: This is a condition where one vertebral body slips forward over the one beneath it. If this results in nerve compression or spinal instability, and conservative measures fail, MI-TLIF can be used.
3. Recurrent Disc Herniation: If a patient has had a prior discectomy and develops a recurrent herniation causing severe symptoms, a MI-TLIF may be recommended.
4. Spinal Stenosis: This condition involves a narrowing of the spaces within the spine, which can put pressure on the nerves. If symptoms are severe and conservative treatment options aren’t working, a decompression laminectomy or a TLIF might be considered.  The decision will be discussed with your surgeon and spine team.
5. Degenerative Scoliosis: In some cases, adult scoliosis (curvature of the spine) can result in back pain and nerve compression. If non-surgical treatment options aren’t effective, a procedure like MI-TLIF might be recommended.
6. Failed Back Surgery Syndrome: In cases where prior spinal surgeries have failed to provide relief, MI-TLIF can be an option to stabilize the spine.
7. Spinal Instability or Fractures: Traumatic injuries, tumors, or infections can destabilize the spine and lead to pain or neurologic problems. MI-TLIF can be a treatment option to restore stability.

In each case, the decision to proceed with MI-TLIF will depend on the patient’s symptoms, the severity of their condition, their overall health, and the potential risks and benefits of the procedure. All surgical procedures come with risks, and these need to be discussed thoroughly with the patient before deciding on surgery. The patient should have also generally tried conservative (non-surgical) treatments first, with surgery considered only if these treatments have failed and the patient’s quality of life is significantly affected.  At Total Orthopedics and Sports Medicine our comprehensive spine team will work closely with each patient, from the initial consultation and review all possible treatment options to design an individualized plan of care.