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Transforaminal Lumbar Interbody Fusion (TLIF)

What is a transforaminal lumbar interbody fusion (TLIF)?

Transforaminal lumbar interbody fusion, commonly known as TLIF, is a cutting-edge procedure offered by our neurosurgeons at NeuroSpine Plus. This surgical technique is designed to alleviate persistent pain and instability in the lower spine by allowing direct access through the intervertebral foramen—an essential passageway for the nerves branching out from the spinal cord to the body.

At NeuroSpine Plus, our surgeons employ TLIF as one of the multiple strategic methods for achieving spinal fusion. TLIF effectively relieves pressure on compressed nerves and eliminates unwanted spinal segment motion, resulting in significant pain reduction.

NeuroSpine Plus is dedicated to providing top-tier spinal care with a focus on minimally invasive techniques, ensuring that each patient receives individualized treatment conducive to accelerating healing and restoring quality of life.


What conditions are treated with a transforaminal lumbar interbody fusion (TLIF)?

Transforaminal lumbar interbody fusion (TLIF) is an effective treatment option for various prevalent conditions causing low back pain and/or radiating leg pain. A TLIF may be recommended if you have:

  • Debilitating spinal pain
  • Spinal nerve compression
  • Myelopathy
  • Spinal stenosis
  • Radiculopathy
  • Leg weakness
  • Leg pain
  • Sciatica
  • Herniated Discs
  • Prior lumbar fusion
  • Neurogenic claudication 
  • Spondylolisthesis

At NeuroSpine Plus, we are dedicated to providing expert, professional care, informed by the latest advancements in spinal treatments. Our comprehensive approach ensures that each procedure is uniquely adapted to the nuances of the individual’s spinal health challenges.

How is a transforaminal lumbar interbody fusion (TLIF) performed?

On the day of surgery, you will be given general anesthesia by a trained anesthesiologist. You will be completely asleep before the procedure begins. Exact surgical details may vary from what is outlined below depending on multiple factors including your past medical and surgical history, preoperative imaging findings, and the complexity of your individualized procedure. During TLIF surgery at NeuroSpine Plus, our experienced neurosurgeons will perform the following steps to address your condition:

  1. An incision(s) is made on the lumbar spine at the site of your planned surgery.
  2. With gentle surgical dissection and retraction, a pathway is created to expose the spine.
  3. The degenerated disc(s) are removed with specialized instrumentation and the affected nerve roots are freed from any bone spurs or compressing disc fragments.
  4. A surgical disc spacer (“interbody”/ “cage”) may be inserted into the space where your degenerated disc used to be.
  5. Titanium screws are placed above and below the disc space(s) to provide stability.
  6. Titanium rods are then used to connect screw heads and locked into place.
  7. The incision(s) will be closed with multiple layers of dissolvable sutures and covered with a dry, sterile dressing
  8. You will likely have a small surgical drain exiting from below your incision. This is to empty any blood remaining from your procedure. It will be removed prior to your discharge.

If advised by your surgeon, you will wear a supportive lumbar brace following surgery. Over time, the levels operated on will ‘fuse’, or grow together, like one continuous bony structure.

What to expect following a transforaminal lumbar interbody fusion (TLIF)?

Your postoperative healing progress will be closely overseen by our team of providers, ensuring a routine recovery. A member of our team will contact you within the first 48 hours of your procedure to monitor your progress. Your initial post operative appointment will be scheduled within two weeks of your surgical date. A member of our team is always available to answer questions or address your concerns during your recovery period. General postoperative recommendations include, but are not limited to the following:

  • Use of postoperative pain medications as prescribed

  • Over-the-counter Tylenol for pain

  • Advance your diet as tolerated as discussed with your team; ensure regular bowel movements.

  • Avoid bending/twisting/ lifting

  • Do not lift greater than 10 pounds

  • Do not smoke

  • Do not drink alcohol

  • Attend all scheduled follow-up appointments

  • Do not use NSAIDs until cleared by your surgeon (Advil, Ibuprofen, Motrin, Aleve, etc)

  • Incision care to include washing your incision with gentle antibacterial soap 48 hours after your procedure. No scrubbing, submerging, or soaking the incision(s). No lotions, creams, oils, or ointments atop the incision(s).

You will likely stay at least one night in the hospital following your surgery. You may be fitted for a lumbar brace either before your surgery, or immediately following your surgery. You may begin walking with assistance on the night of surgery. A representative of the surgical team will see you each day of your hospital stay to monitor your care ensuring your pain is well-controlled and you are healing properly. The drain exiting from below the incision will be removed once it has been determined safe to do so by the provider. Discharge is dependent on the clearances from either physical therapy, occupational therapy, internal medicine, neurosurgery, consulted specialists, and/or all of the above. At NeuroSpine Plus, we encourage an active recovery, with many patients walking up to two miles within the first two weeks following their procedure. Our specialized minimally invasive TLIF technique can help mitigate soreness and enable an earlier return to activities due to the reduced muscle dissection involved.

When should you call your doctor following a transforaminal lumbar interbody fusion (TLIF)?

If you have concerns during your postoperative period to include, but not limited to the following:

  • High fever greater than 100.4F
  • Change in urinary or bowel habits
  • Swelling or discoloration of one or both calves
  • Shortness of breath
  • Chest pain
  • Palpitations
  • Lightheadedness
  • Incisional compromise
  • Loss of strength in your arms or legs

If you have a question regarding your initial postoperative period, a member of our team is always available to answer and address your concerns at 201-399-3388.

Transforaminal lumbar interbody fusion (TLIF) FAQ

To understand what TLIF is, let’s break it down according to the different steps. 

  • Transforaminal:  A surgical approach through your foramina, or the opening the nerve travels through
  • Lumbar: Conducted on the intervertebral discs of your lumbar spine 
  • Interbody: The disc spacer, or ‘cage’, is inserted once the damaged disc has been carefully removed, replacing a damaged disc between two or more of your vertebrae. 
  • Fusion: Over time, the levels operated on will ‘fuse’, or grow together, like one continuous bony structure.

All surgical procedures have an inherent level of risk associated with them. With the TLIF procedure performed by our board-certified neurosurgeons, the risks are rare. All risks and benefits associated with undergoing any surgery at NeuroSpine Plus are discussed at length with our board-certified neurosurgeons prior to proceeding with your procedure. 

A TLIF has several advantages, which include:

  • Enhanced spinal stability and alignment
  • Higher fusion success rates because of direct access to disc space
  • Active recovery and rehabilitation
  • Lower risk of postoperative complications and infections
  • Using specialized tools and real-time X-ray imaging with the aid of a microscope, Dr. Scheid and Dr. Hunt routinely perform TLIF procedures with minimal residual scarring or postoperative pain.

If you believe you may be a candidate for a TLIF procedure, call our office today to book your consultation at 201-399-3388.

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