Transforaminal Lumbar Interbody Fusion


What Is A TLIF?

A TLIF (Transforaminal Lumbar Interbody Fusion) is a type of Spinal Fusion procedure used to treat conditions of the lumbar spine.  This procedure may be performed as a Minimally Invasive or open procedure, depending upon the location of the damaged discs.   This procedure uses a posterior approach (from the back) to access the affected discs of the spine.  A TLIF is often indicated for those with degenerative disc conditions, spondylolistheis or multiple disc herniations.

The goal of this procedure is to remove the spinal disc and/or bone spurs that are causing irritation of the spinal nerves and use internal fixation to stabilize the spine and relieve the pain associated with lumbar spinal conditions.

How is a TLIF Performed?

In the Minimally Invasive approach for this procedure, an incision (usually 1-2 inches) is made directly above the damaged spinal disc or vertebrae and the muscles are gently retracted to the side. Unlike traditional spinal fusion surgeries, muscles are not cut or dissected and surgical tools and implants are slipped between or around the muscles.

Next, under fluoroscopic guidance (real time X-ray visualization) the impinged nerve is identified and placed to the side so that a substantial amount of the intervertebral disc and/or bone material can be safely removed.  A small implant, which also contains bone graft, is placed into the disc space to restore normal height and stability to the disc space.  The bone graft implant creates a biological response and, over time, this bone graft will knit together with the adjoining vertebrae and form one contiguous and stable vertebra.  Additional bone graft material may also be placed along the edges of the vertebrae to expedite the fusion process.

Next, small rods and screws are placed between the two vertebrae to ensure stability.  The incision is then closed with small stitches.

In most cases, a TLIF can be performed on an outpatient basis due to the reduced trauma to the spine and muscular structures.   In fact, most patients are up and walking shortly after this procedure and physical therapy will begin within a few days of the procedure.