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Transforaminal Lumbar Interbody Fusion, or TLIF, is a surgery performed to stabilize the spine and treat back and leg pain. Fusion surgery joins two or more vertebral bones together to avoid abnormal movement that is causing discomfort.

Candidates for TLIF
TLIF surgery is usually performed on patients who have disc degeneration or instability, spondylolisthesis, or nerve compression. These conditions can cause significant back pain, leg pain, numbness or weakness. If more conservative treatments like medication, physical therapy or injections have not provided relief, TLIF surgery may be recommended by NYC Spine Surgeon Dr. Fischer at NYU Langone Medical Center in New York City.

Minimally invasive approach
As opposed to traditional open surgery, minimally invasive spine surgery may be an option for the TLIF procedure. It is performed through small incisions in the back and special instruments like tubular retractors, microscopes, and intraoperative X-rays are used to limit damage to the patient’s back muscles. Minimally invasive surgery has smaller incisions and scarring, less blood loss, shorter hospital stays, less pain, and faster recovery compared to traditional surgery.

TLIF surgery is done using general anesthesia and typically takes several hours from start to finish. Using an X-ray to find the ideal location, usually two small incisions are made in the lower back to begin the procedure.  Dr. Fischer avoids cutting into nearby muscles and uses special instruments to separate the tissue and allow spinal access. A microscope provides the ability to see close-up details during the procedure. Damaged disc material is removed and bone graft or synthetic substitute is inserted between the vertebrae to provide stability and promote bone fusion. Titanium screws and rods are often used to aid in positioning and healing.

Most patients spend 2-4 days in the hospital, before being released with restrictions like no heavy lifting and no repetitive bending or twisting movements. After 4-6 weeks, most TLIF patients return to light duty work, avoiding heavy labor until 9-12 months post-operation. Physical therapy is an important element of recovery, beginning after 6-12 weeks following the procedure. Regular checkups with Dr. Fischer at NYU Langone Medical Center are scheduled and X-rays are used to monitor bone fusion and overall recovery.

Risks versus benefits
Serious risks such as infection, nerve injury, bleeding or fusion failure are uncommon after minimally invasive TLIF. Most patients experience dramatic improvement in their back and leg pain once recovery is complete.  To learn more about TLIF, schedule a consultation with Dr. Fischer today.