Transforaminal Lumbar Interbody Fusion (TLIF)
Transforaminal lumbar interbody fusion (TLIF) is a contemporary approach to spinal fusion surgery. It is an operation performed on the lower back to remove an intervertebral disc and join two or more spinal bones (vertebrae) together using screws and a cage.
A Transforaminal Interbody Lumbar Fusion is a particular type of fusion, or surgical procedure that permanently fuses, or unites, bones of the spine. The fusion is achieved using bone graft: bone material either acquired from a bone bank or transplanted from elsewhere in the patient’s own body. Over time, the bone graft and the bones of the spine grow together, forming one united bone. A Transforaminal Interbody Lumbar Fusion treats spinal instability or weakness by permanently uniting bones of the lumbar (lower) spine. The goals of a TLIF are to decompress (remove the pressure from) the spinal cord and/or nerves, re-stabilize the spine, and prevent further movement and degeneration at the joints in question
- A TLIF is performed under general anesthesia, which means the patient is unconscious.
- The surgeon makes an incision in the lower back over the bones of the spine. If material for a bone graft is to be retrieved from the patient’s own hip, this incision can also be used to retrieve the bone.
- The surgeon removes a portion of bone and joint at the back and side of the vertebra. These sections of bone and joint are called, respectively, the lamina and the facet joint. The facet joint helps form the borders of the foramina, and the surgeon identifies and protects the nerves traveling through the foramina above and below the removed facet joint. This bony removal helps relieve the pressure on the spinal cord and/or nerves, and it also allows the surgeon space to access the disc between the vertebral bodies at the front of the spine.
- The surgeon then uses specialized instruments to remove a portion of the intervertebral disc between the vertebral bodies. The surgeon places a spacer (a supportive device) between the vertebral bodies, where the disc once was. The spacer holds the vertebrae the proper distance apart, just as the disc once did.
Hip resurfacing involves trimming of the femoral head and capping with a metal cover. It also includes removal of the damaged bone and cartilage in the socket and replacing it with a metal shell. This procedure can preserve more of the bone and prevent the development of possible complications which are associated with the traditional hip replacement surgery.
Benefits of TILF
- Reduction of leg pain, numbness, tingling and weakness
- Reduction of back pain
- Stabilisation of an unstable spine
- Medication reduction
- Prevention of deterioration
- Improved lower back and leg function
- Improved work and recreational capacity
- Improved quality of life
What Do I Need to Do Before Surgery?
Before your surgery it is imperative that you stop smoking, and you should not smoke for at least 12 months after. Smoking impairs the fusion process and leads to worse outcomes following spinal surgery.
If you are fairly overweight, it is advisable that you engage in a sensible weight loss program before you surgery. Please discuss this with your GP and neurosurgeon.