Transforaminal Lumbar Interbody Fusion (TLIF)

transforaminal lumbar interbody fusion ( TLIF ) is a surgical procedure to stabilize the spine and reduce back pain and leg by the union of two or more vertebrae to prevent abnormal motion .

Who is a candidate for a transforaminal lumbar interbody fusion?

Patients with back pain and leg pain lumbar fusion surgery, weakness or numbness that failed conservative measures (physiotherapy, medications, transforaminal lumbar interbody fusion, etc. ) and have evidence of disc degeneration or instability MRI are candidates for a transforaminal lumbar interbody fusion.

What is the minimally invasive surgical approach?

lumbar fusion surgery minimally invasive spine is performed through small incisions in the back and used intraoperative X-ray microscope transforaminal lumbar interbody fusion, tubular retractors, and special instruments to prevent significant damage to the back muscles .

Minimally invasive lumbar fusion surgery has many advantages of traditional spine surgery (or open), including smaller incisions transforaminal lumbar interbody fusion, less surgical blood loss , smaller scars and a shorter hospital stay , less pain during recovery and a return Quick to work and daily activities .

What happens during the transforaminal lumbar interbody fusion surgery?

The patient is placed in a local operating and placed under general anesthesia with a breathing tube for the duration of surgery transforaminal lumbar interbody fusion, usually about 3 to 4 hours for a single level procedure . X -ray is used to plan two small ( about 2 inches long) small incisions back - one on each side of the median line lumbar fusion surgery - through which the operation is performed. If intraoperative scanner and navigation 3 - D are used , a small incision is made ​​in the basin to secure the navigation transforaminal lumbar interbody fusion frame.

Without cutting through the muscles lumbar fusion surgery, a series of dilators are used to separate the muscle fibers and to provide access to the spine transforaminal lumbar interbody fusion. A spacer is positioned on the dilator and provides a working channel for performing the operation. A microscope is used to provide a close-up view during the procedure.

Bone spurs are lumbar fusion surgery removed and the ligament covered to create more space for the nerves in the spinal canal. The major part of the disc between the vertebrae is then removed to create the space for bone transforaminal lumbar interbody fusion.

Then an entirely synthetic spacer own bone fragments and patients plastic is inserted between the vertebrae . The spacer provides support to the transforaminal lumbar interbody fusion and helps the bone fusion. Additional plastic material is placed around the spacer to stimulate bone growth .

Titanium screws are inserted into the vertebrae above and below the separator and interconnected by rods titanium lumbar fusion surgery. This provides support to the spine transforaminal lumbar interbody fusion, while the bone over time merge . Screws and rods do not need to be removed and not sound the metal detector at the airport.

The incisions are closed with sutures that are under the skin and dissolve over time , so no suture removal is necessary . Sterile dressings are placed over two days stay transforaminal lumbar interbody fusion. If surgery is two or more levels , or if the patient has risk factors for the fusion of not having a back of the belt and / or a bone growth stimulator takes over six weeks after surgery transforaminal lumbar interbody fusion, otherwise clamping is not required.

Transforaminal Lumbar Interbody Fusion

Spinal fusion is an invasive surgical procedure performed to ensure stability of the spinal column in the case of degenerative disc disease , nerve impingement and / or the movement of the cord ( spondylolisthesis) . The surgery involves the removal of a transforaminal lumbar interbody fusion or a disc and the positioning of a bone graft into the disc space to fuse the vertebrae together . Grafts and additional hardware may be used outside of the spine for stability. 

Anterior interbody lumbar fusion ( ALIF ) is a type of spinal fusion surgery is often performed to treat degenerative disc disease , where he lost a lot of disc height . Anterior fusion is performed through an incision in the stomach transforaminal lumbar interbody fusion. There are other approaches that dictate approaching from behind or the side, but the anterior approach is sometimes favored by his avoidance of the back muscles and spinal nerves .

ALIF generally not performed on individuals with an unstable spine caused by spondylolisthesis (vertebral fracture and movement transforaminal lumbar interbody fusion ) or higher Disk space . In such cases , a posterior approach can be combined with ALIF provide additional sites for the fusion .

Each type of surgery has its own risks transforaminal lumbar interbody fusion. The risk of all types of fusion surgeries are shared failure of the merger , bleeding , infection and scar tissue .

Fusion earlier presents unique risks because of its development of the front body . A possible complication after surgery is the disembowelment transforaminal lumbar interbody fusion. A hernia is present as the wall of the abdominal cavity , the peritoneum , pushed through a small hole or a part of the connective tissue surrounding the abdominal muscles and form a bag transforaminal lumbar interbody fusion. 

Incision in the abdomen can cause little or as hole points transforaminal lumbar interbody fusion. A hernia can be visibly protrude and retract when coughing or lifting. If it is painful to touch or retracts when pushed in , is likely to need surgery to repair the weak spot in the abdomen. Parts of organs can be taken into the hole that the bag expands and the blood supply can be cut, strangle this transforaminal lumbar interbody fusion body part.

For men who seek fusion L5 -S1 disk space, retrograde ejaculation is a concern. The anterior approach to surgical tools for spinal segment placed near nerves innervating a body transforaminal lumbar interbody fusion ejaculate valve operation. If the damaged nerve supply and the valve does not open , ejaculate will be directed to the bladder. 

While this does not pose a risk to health or the pleasure of feeling men , provides various complications with the design. Exact incidence is unknown, transforaminal lumbar interbody fusion but could be 5 % or more, depending Spine.org for men who seek anterior fusion at the L5 -S1 segment.

A minimally invasive manner is available ALIF requiring a smaller incision and using a laparoscope , or a room, which guide the surgeon's tools transforaminal lumbar interbody fusion. Although this procedure usually promises a shorter recovery time and less scarring ,transforaminal lumbar interbody fusion but also represents a unique risk to large blood vessels, the vena cava and the aorta, lying on his back and travel to the lower body. 

Normal ALIF can damage these vessels at a rate of 1-2 % incidence,transforaminal lumbar interbody fusion risk increases with anterior fusion as laparoscopic surgeon for mobility in the way of limited incision. Interference with these blood vessels is a major concern because it transforaminal lumbar interbody fusion causes excessive bleeding.

When considering surgery , it is always important to weigh the risks and potential benefits. Although most surgeons have rates of 95% or more fusion transforaminal lumbar interbody fusion, some studies put the much lower rate . A small study with 85 participants found that the overall rate of fusion was 80%. 

The study also indicates the results based on the level of fusion , the failure rate was much higher (31 %) of the L3- L4 to L5 -S1 (16% ) level transforaminal lumbar interbody fusion. These are all factors to consider when deciding whether surgery and this surgery is worth the risk for your transforaminal lumbar interbody fusion unique situation