TLIF Spine Surgery : Procedure, Cost & More

Transforaminal lumbar interbody fusion (TLIF) is a lower spinal surgery in which two spinal bones (vertebrae) are joined by removing the discs between them. This helps relieve back and leg pain. When is TLIF spine surgery suggested? How is TLIF surgery done? How much does TLIF surgery cost ? Well, let’s get into some in-depth facts about TLIF spine surgery and its outcomes! 

Transforaminal lumbar interbody fusion (TLIF), also known as TLIF surgery, TLIF spinal surgery, or TLIF spinal fusion surgery, is a surgery of the lower back to relieve chronic back and leg pain.

During this procedure, two spine bones (vertebrae) are joined to prevent their mobility, and some portions of discs between them are removed and supplemented with a bone graft, rods, and screws. In simple terms, a surgeon removes the cushioning (discs) between two spine bones and fuses them to prevent their motion. This procedure is done to reduce back and leg pain. 

So, now you know that TLIF surgery in full form is “transforaminal lumbar interbody fusion”. However, what do each of these terms mean? 

• The term "transforaminal" in the procedure means that the operative spinal area is accessed through a natural opening in the spine called the neural foramen or foraminal opening (transforaminal). 
• The term “lumbar” refers to the lower back, specifically the five vertebrae between the ribcage and the pelvis.
• The term "interbody fusion" refers to the placement of an interbody fusion cage between the adjacent vertebrae. The interbody fusion cage contains bone graft material to stimulate bone growth, fuse vertebrae together, and stabilize the spine. 

Find experienced orthopedic surgeons near you and get this advanced surgery done!

There are two approaches to performing TLIF spine surgery i.e., open TLIF and minimally invasive TLIF spine surgery

1. Open TLIF:

A surgeon makes a large incision (2 to 4 inches long) in the center of your lower back to access your lower bone. Surgical instruments are used to remove a portion of the backbone to access the damaged disc. A tool is inserted into the passage to remove the intervertebral disc (middle layer of the disc). This relieves pressure on the nerves causing chronic back and leg pain.

A surgeon places a bone cage (a type of support pad) along with some bone graft material inside to improve spinal stability and prevent its motion. To add more stability to the vertebrae, a surgeon drills screws inside the vertebrae and places rods that are bolted on top to prevent motion. This adds an extra layer of stability to your lower back and reduces symptoms of back and leg pain. 

2. Minimally Invasive TLIF: 

A surgeon makes a 1-inch incision to the side of the lower back where the affected disc is located and a fluoroscope (a device that projects live X-ray images) is inserted to show the exact location of the spine. The surgeon removes a part of the backbone to access the damaged disc. 

The worn-out disc is removed and a bone cage that acts as a support pad is placed in between the vertebrae. Some bone graft material is added to support the bone cage. A surgeon then drills screws into the lower back of your spine and places rods on top to add more support. The incision is closed with dissolvable sutures. 

In most cases. individuals with chronic back and spine pain associated with sciatica (nerves that run from the lower back to the legs) can benefit from TLIF spine surgery. Some of these conditions include: 

• Herniated (slipped) disc
• Vertebrae fracture
• Scoliosis and kyphosis (spinal deformity)
• Spinal instability and weakness (caused by a tumor or infection)
• Spondylolisthesis (a spine condition that results in lower back pain due to the slipping of one vertebral body over another)
• Degenerative disc disease (worn-out disc/cushioning between two spinal bones)
• Pseudoarthrosis (the absence of a solid fusion from a prior fusion surgery)

The TLIF procedure consists of the following stages:

Before Surgery:

• Make sure you discuss the surgery at length, including the procedure, your expectations, the benefits, risks, and any questions you may have. 
• The doctor will discuss your medical and surgical history in detail before the surgery. Your symptoms and current medications are also discussed. 
• The doctor will also assess your overall health condition with certain tests including:
  • Radiography: An imaging technique that uses X-rays to detect the extent of structural damage caused. This test will also assess the levels of spine severity.
  • Electromyography: An EMG test will reveal nerve, muscle, or nerve-to-muscle dysfunction.
  • Myelogram: This test shows the spinal cord, nerves, roots, and bones and if there is anything that’s pressing against it. 
  • Magnetic Resonance Imaging (MRI) Scan: This scan can detect problems with the spinal bones, surrounding soft tissues, spinal nerves, and discs.
  • Computed Tomography (CT) Scan: Provides detailed information about spine structures, diseases, or injuries to the spine. 
  • Nerve Conduction Studies: These tests may be performed along with giving a nerve sheath injection with a local anesthetic to confirm which nerves are causing your symptoms.

During Surgery:

At Medfin, we offer the best and most advanced surgeries that are painless and scarless, ensure faster recovery, and require no hospital stay. Find the best orthopedic surgeons near you . A minimally invasive TLIF spine surgery involves the following steps.

TLIF Surgery Time: 90 minutes

The TLIF surgery steps are as follows:

STEP 1: You will be administered general anesthesia.

STEP 2: The surgeon makes a 1-inch incision to the side of the lower back with the affected disc and a fluoroscope is inserted to project images to a screen. 

STEP 3: The surgeon removes the damaged disc and a bone cage (padding) with bone graft material is placed inside. 

STEP 4: The surgeon drills a screw into the backbone and places rods that are bolted on top to build stability in your lower back.

STEP 5: The incision is closed with dissolvable stitches.

After Surgery:

• Immediately after the TLIF procedure steps are complete, you will be moved to a ward and kept for further observation for about 2 days or more. 
• During this time, healthcare professionals will:
  • Check for signs of any infection or fever.
  • Prescribe painkillers.
  • Make you undergo a CT scan a day post-surgery. This will give them a better insight into the rebuilt spine structures.
  • Assign a physical therapist to you to improve motion and help build spinal stability. 
  • Prescribe a spinal brace to build stability in your spine and aid in faster recovery. 
  • Ask you to avoid heavy lifting, twisting, or continuously sitting for long periods. If you experience numbness or tingling sensation, call your doctor immediately. 
• You can return to work in about 4 to 6 weeks depending on your doctor's advice. However, if you are associated with a highly demanding physical job, talk to your doctor and take the necessary precautions. 
• Have regular follow-up appointments with your doctor in the weeks after your surgery. This will ensure a faster recovery.

Benefits

The benefits or advantages associated with transforaminal lumbar interbody fusion (TLIF) surgery include:

• Reduction in pain caused by spinal conditions
• Improved stability of the spine and reduced risk of further injury or damage to the affected area
• Better spinal function
• Quicker recovery as compared to traditional spinal fusion surgery
• Reduced risk of complications such as infection and bleeding

Risks

The risks or potential complications of transforaminal lumbar interbody fusion (TLIF) surgery include:

• Infection
• Hemorrhage
• Blood clots
• Failure of fusion of the bone graft
• Nerve damage
• Persistent pain
• Bone graft migration
• Failure or dislodging of the screws, rods, and other hardware used during surgery

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!