Percutaneous Transforaminal Lumbar Interbody Fusion

Transforaminal lumbar interbody fusion (TLIF) is a procedure that involves removing an intervertebral disc from between two vertebrae and fusing them together through key-hole incision in the back.

Traditionally, TLIF has been performed as an "open" technique with a larger midline incision at the back.
Through this incision, the surgeon cut or strip muscle and tissue to access the vertebrae and disc space which is part of the reason that after the surgery, patients are faced with a long recovery period.

Unlike the traditional TLIF procedure, our surgeons perform the TLIF by percutaneous technique with small keyhole incisions in the back. Without needs to strip muscle out of the bone, patients will have much less pain after surgery, loss less blood during surgery and get back to normal life much faster.

Moreover, surgeons at Bumrungrad Spine Institute also combine the advantages of percutaneous TLIF with use of the advanced surgical navigation system called ‘O-arm’. The O-arm acts like GPS device in a car. Surgeons will see real-time high quality 3D images during surgery which resulted in more than 99% precision. These benefits lead to a shorter hospital stay and more rapid patient recovery time.
This procedure is used to achieve spinal fusion in patients who are diagnosed with severe lumbar spondylosis or spinal instability (spondylolisthesis) and to relieve symptoms.


The percutaneous TLIF is performed under general anesthesia. After the patient is positioned, the O-arm will be used to create 3D images prior to the surgery. Screws will be placed through keyhole skin incisions. Then the degenerative structures that cause nerve compression will be removed through a small tunnel with help of microscope. A bone graft is then inserted into the disc space and will act as a bridge until the bone is formed.


  • Much shorter hospital stay compared to the traditional technique.
  • Much less postoperative pain
  • No blood transfusion needed
  • More than 99% precision.
  • Walk within 24 hours after surgery
As with any spine surgery, there are risks, including the possibility of:
  • General complications of any surgery including bleeding, infection, blood clots and reaction to anesthesia
  • Adjacent segments degeneration syndrome
You are advised to discuss the potential risks and complications with your surgeon prior to having TLIF surgery. However, risks from any surgery can be reduced by following the surgeon's instructions before and after the back surgery.

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