MIS Transforaminal Lumbar Interbody Fusion (TLIF)
Overview
The goal of this procedure is to stabilize the spine, minimizing low back and leg pain. This procedure stops the motion of the affected disc level by placing screws, rods and bone graft to promote the two vertebrae to become one bone (spinal fusion). Dr. Rodriguez does this procedure through a minimally invasive approach, reducing pain and recovery time.
Benefits:
The specific advantages of the MIS TLIF are to minimize the risks and maximize the speed to recovery compared with traditional open spine surgery. With the MIS TLIF muscle damage and pain intensity are greatly reduced.
- High Success Rate In Reducing Back And Leg Pain
- Reduced Blood Loss and Infection rate
- Minimal Incision and Scarring
What Are the Indications For MIS TLIF?
- At Least 3 Months Of Nonsurgical Treatment
- Suitable General Health for Safe Anesthesia
- Mechanical Low Back Pain And Radicular Pain Associated With Spondylolisthesis (Instability)
- Severe And Chronic Back Pain
- Severe Stenosis
How Is The MIS TLIF Performed?
Two 2-3 cm incisions are made on either side of the lumbar spine at the affected level. After incising the skin, a minimally invasive approach is made down to the vertebral body using dilating tubes. Spinal screws are placed and secured into the vertebral body of spine. To place the screws accurately, live x-ray, direct visualization and live nerve monitoring are used to minimize any risk.
After the screws are placed, Dr. Rodriguez removes any bone and disc compressing the spinal nerves. A plastic spacer and donated bone graft are implanted within the disc space becoming a scaffold and bridge to promote a fusion from one level to the next.
Additional donor bone graft is placed between the screws laterally to further support and promote a solid fusion between the two vertebral body levels. This fusion provides stability for the spine by stopping movement that used to cause mechanical pain when the patient moved. The surgery also provides complete decompression of any pressure on the nerves at this level.
What Is The Recovery After MIS TLIF?
Most patients stay in the hospital overnight until the next afternoon. The overnight stay allows for adequate training with a physical therapist and establishes good pain control with medications before the patients goes home. After the surgery, all patients wear a back brace when out of bed for 3 months to provide support for the muscles, reduce the use of pain medications, and diminish the stress on the screws that have been placed. In patients that are at high risk of the bones not fusing together, Dr. Rodriguez often orders an external bone growth stimulator to minimize this risk. Patients can return to light duty jobs as early as 6 weeks out from the surgery; however, Dr. Rodriguez usually recommends that the patients plan on being off of work for 3 months. Heavy labor positions may require 6 months to 12 months before full release to work.
What Are The Risks of MIS TLIF?
The MIS TLIF surgery, like any other surgical procedure, has certain potential risks and complications associated with it. Dr. Rodriguez will discuss all potential risks of surgery and answer all of your concerns prior to any decision to move forward with surgery.
Risks and complications that are possible with an MIS TLIF include but or not limited to:
- Post-Surgical Infection
- Bleeding
- Nerve Damage
- Tear Of The Dural Nerve Sac
- Non-Fusion Resulting In Additional Surgery
Because of the minimally invasive approach, the risks stated above for bleeding or infection are greatly reduced. Dr. Rodriguez uses nerve monitoring during surgery to minimize the risks to the spinal cord and any nerves. To reduce the risk of improper placement of screws and rods, Dr. Rodriguez uses live x-ray monitoring from multiple angles to assure proper placement and alignment of the hardware in the spine. He also tests the screws with nerve monitoring to make sure they are properly placed. In patients with certain risk factors (i.e. smokers or diabetes), Dr. Rodriguez uses an external bone growth stimulator to diminish the risk of bones not fusing. The stimulator enhances the fusion bone growth and reduces the likeliness of future surgery.
