What is minimally invasive TLIF (transforaminal lumbar interbody fusion) procedure?
TLIF is a minimally invasive surgery to achieve lumbar spinal fusion in patients who have spinal instability (spondylolisthesis). Traditional spine surgery involves cutting or stripping the muscles from the spine, but a TLIF can be performed using small incisions.
How is it done?
Minimally invasive TLIF procedure is performed under general anesthesia. The surgeon uses two incisions and muscle dilation to gently separate the muscles surrounding the spine.
After the spine is accessed, the lamina (“roof” of the vertebra) is removed to allow visualization of the nerve roots. They are moved to one side and disc material is removed from the front of the spine. A bone graft, which acts as a bridge to allow new bone to grow, is then inserted into the disc space. Screws are inserted to stabilize the spine while the treated area heals and fusion occurs. The surgeon then closes the incision, which usually just leaves a small scar. The spine surgery usually takes from four to six hours.
Why is it done?
Spinal instability may include back pain, numbness and/or muscle weakness in the lower back, hips and legs The procedure is designed to relieve such symptoms and benefits include a smaller wound and a shorter hospital stay.
Risks and complications
As with any spine surgery, there are risks, including the possibility of:
- Nerve root injury with progression of neurological deficit such as weakness, numbness or urination and defecation problems.
- Bleeding from blood vessels.
- CSF (cerebrospinal fluid) leakage.
- Wound infection.
- Radiation exposure.
- Complication of screws placement such as malposition, fracture of screws, rods, artificial cage or bone.
- Blood clots in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism).
- In some cases, the complications may occur up to a year following the surgery.
Good candidates for this spine surgery are patients with symptoms of instability of the spine such as back pain related to posture or radicular pain. Candidates also should not have too much bone displacement (spondylolisthesis). Patients with severe osteoporosis have a higher risk of screws displacement and will not be good candidates for spinal fusion.
Preparing for the minimally invasive TLIF procedure
You will receive pre-operative evaluations with X-ray imaging, MRI imaging and a general medical assessment before surgery. Please inform the doctor about your medical history, drug allergie, current medications especially antiplatelets and anticoagulants such as aspirin and warfarin. Such medicines should be stopped at least one week before back surgery.
You should be able to resume walking the day following the procedure. Patients generally stay in hospital less than a week following surgery.
Regular Service Hours
Daily : 8 a.m. to 8 p.m.
Bumrungrad International Clinic building, 12 Floor, station B
33 Sukhumvit 3 (Soi Nana Nua), Wattana, Bangkok, 10110 Thailand
Phone 66 (0) 2667-1515