Transforaminal Interbody Lumbar Fusion (TILF)

TILF is generally used to treat back or leg pain caused by degenerative disc disease. The surgeon will stabilize the spine by fusing vertebrae together with bone graft material.

About the Surgery

Transforaminal Interbody Lumbar fusion is a surgery that is used to cure spinal weakness or instability by uniting lumbar or lower spine bones permanently. 

TLIF surgery aims to remove or decompress the pressure from the spinal cord nerves,  spine stabilization, and preventing further degradation at the joint.

Over a  specific period, this fusion grows into one solid single bone. A Transforaminal Interbody Lumbar fusion (TLIF) surgery can be carried in one of the several invasive ways to reach the target area,

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  • Degenerative disc disease with a specific discogenic pain pattern.
  • Low grade 1 or grade 2 spondylolisthesis.
  • Instability of the anterior column in association with posterior pathology.
  • Previous decompression for a herniated disc.
  • Decompression in association with micro-instability, spondylolisthesis

 A full physical examination will be conducted by the doctor to see if the patient is in good health to undertake the surgery.

  • The patient’s medical history is thoroughly studied so as to avoid any complications arising during or after the surgery. 
  • Medications such as blood thinners are advised to be stopped, a week before the surgery is due to take place.
  • The patient is to fast for a minimum of 8 hours before the surgery. 
  • TILF procedure is performed through a posterior incision exposing the back of the spine.
  • Pedicle screws are placed into the vertebra.
  • Exposure of the disc space is done on one side by removing the facet joints and protecting the nerve roots.
  • The disc space is entered and disc material is removed.
  • The bone graft is obtained from the patient’s iliac crest (the hip).
  • A spacer or interbody cage that is filled with bone graft is placed into the disc space to maintain the disc height.
  • Additional bone is placed in the lateral (side) gutters of the vertebrae and the disc space.
  • Pedicle screws are attached to rods or plates.
  • The wound is closed.
  • Physical therapy is begun the day
  • A spinal brace may be used.
  • Limited activity
  • Infection
  • Blood loss
  • Nerve injury
  • Possible re-operation
  • Lack of a solid fusion
  • Continued pain or (rarely) increased pain

Medfin finds you the best surgeons across India

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Dr Kumaraswamy M

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Dr Harjoban Singh
Dr Harjoban Singh

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Dr Gopikrishna Reddy G
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Dr M Muthu Sarvana Kumar
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Dr Harramb Mithal

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  • His career spans over 18 years of Orthopaedic experience with special interest in Advance Arthroscopic Surgery, Sports Injuries, Joint replacement and Complex Trauma.
  • His exposure to sports injuries came from London Olympic Hospital 2012 , exposing to vast amount of complex sports injuries on and after London Olympics 2012 .
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Dr Sai Krishna B Naidu
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FAQs and Related Articles

After the TILF, the patients improve 60% to 70%. Nearly 80% of patients who undergo TILF are satisfied with the result after the surgery.
The duration of surgery may vary from 2 hours 30 minutes to 6 to 7 hours.
Transforaminal Lumbar Interbody Fusion is a spinal fusion surgical procedure. In this surgery, the surgeon removes an intervertebral disc and joins two or more spinal bones (vertebrae) together using a cage and screws.
Yes, some patients will have leg pain after lumbar fusion surgery. Kindly consult your doctor for more information.
If you are experiencing pain even after the fusion then the level above or below a segment that has successfully fused can break down. This will become a new source of pain and is called adjacent segment disease.
The worst pain of the surgery will be generally over within four weeks after the surgery. After that, the pain will decrease gradually. In rare cases, the patients might have pain even up to 3 months to 6 months after surgery.
In Transforaminal Lumbar Interbody Fusion the surgeon or the doctor access your spine from the side of your body and it is unilateral access. And in Posterior Lumbar Interbody Fusion the surgeon or doctor access your spine from the posterior side (from your backside).
If you decided to sleep on your side after the surgery then you should bend your knees and tuck a pillow between your legs. It is important that your legs while bent should rest right on top of each other. Else if you sleep on your back, you should bend your knee and hips bent and you will have to tuck a pillow under your knees.

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