Transforaminal Lumbar Interbody Fusion, abbreviated TLIF, is a type of lumbar (lower back) spine surgery thatfi combines one or more interbody devices (such as a cage) with bone graft article to stimulate bony fusion. Transforaminal means through (trans) the foramen. The neuroforamen are natural openings created between two vertebrae (Fig. 1).

Figure 1

The term bony fusion means new bone grows to join two or more vertebrae together. While interbody devices are used to fill the disc space after discectomy (or microdiscectomy), other spinal instrumentation may be included to increase spinal stability. Spinal instrumentation generally refers to different types of plates, rods, and screws that secure or fix the spine in position.

Depending on your spinal disorder, number of levels to be treated, and other factors, surgery may be performed as an open approach or minimally invasive surgery (MIS). An open approach requires a long(er) incision and involves cutting through muscle and other soft tissues to gain access to the intervertebral disc(s). Minimally invasive surgery uses small incisions (some puncture-like) and specialized equipment such as dilatational devices to gently separate muscle and soft tissue. Your surgeon will explain what your surgical procedure may involve, as well as intended benefits and possible risks and complications.

TLIF Procedure

The procedure is performed using image-guidance and involves facetectomy. The term facetectomy means removal of a facet joint (Fig. 2). Posterior to each vertebra are two facet joints. During the procedure, a partial or complete facetectomy is performed on either the right or left facet joint. This allows visualization and removal of the intervertebral disc.

Figure 2

After discectomy, one or two interbody devices (such as cages) are filled with bone graft and implanted in the empty disc space. More bone graft is packed around the interbody device. TLIF involves posterior fusion and the use of spinal instrumentation to provide spinal support and stability.

Potential Benefits, Risks, and Complications

• MIS TLIF reduces trauma to the spine's muscles by allowing them to be separated and not cut.
• TLIF requires less retraction of the nerve roots, limiting the potential for nerve root injury.

We Can Help You Make Informed Decisions

Spine surgery is an important decision. While the final decision is yours to make, the benefits and potentials risks and complications require careful consideration. We look forward to answering your questions and helping you to resolve your concerns about any treatment offered by Piedmont Spine Center.