Posterior Lumbar Transforaminal Interbody Fusion (TLIF) – Mini-Open and Minimally Invasive Techniques

A PLIF or TLIF procedure is a variation of a lumbar posterior reconstruction and fusion. In addition, this procedure includes a full discectomy of the collapsed and painful disc in the lumbar spine, a bone graft and usually a spacer (cage) that holds open the lumbar disc space. This adds a lot of structural support to the fusion and biomechanically adds support to the entire spinal column.

This surgery is performed under general aneasthetic and has the patient face down in a safe and cushioned positioned. A 10-12cm incision is made in the small of the back. After the pedicle screws and rods are placed in the vertebral bones that are to be fused, the back of the disc on either one (TLIF) or both sides (PLIF) is exposed. Careful protection of the exiting nerve roots off the side of the spinal cord (cauda equina) is essential.

The disc material is removed using special instruments and usually a single cage or a pair of cages is placed into the space where the disc once was. Bone graft fills the disc space and cages and usually permits a solid fusion between the two vertebral bones being fused.

Relief of leg pain is often immediate with patients requiring 5-7 days stay in hospital followed by post-operative physiotherapy.