Transforaminal Lumbar Interbody Fusion (TLIF)
November 02, 2017
By Alexander Germanis
There are certain things in our lives that we take for granted and only take notice of when something goes wrong. This can certainly be true of our homes and automobiles and, unfortunately, it often occurs with our own bodies.
Our backs or spine can be one of those things we simply take for granted. Most spine problems are primarily caused by our supporting muscles, although more serious problems can arise, which can cause debilitating pain and weakness.
Our spinal column protects and distributes the collection of nerves that make up a major portion of our central nervous system. It is important not to delay care when experiencing pain and or muscle weakness.
When severe back pain does arise, however, spine surgeons, like Dr. Nitin Kukkar of Orthopedic Sports Enhancement Center, are there to help. In talking to his patients he says, “We never do surgery unless we have failed every other conservative management option, including injections and physical therapy,” the doctor assures. “But having said that,” he continues, “some people do need surgery and if they do, we have these newer procedures.”
If a patient needs a spinal fusion, which is when one vertebral body is joined through a bony fusion to an adjacent vertebral body, there are new minimally invasive type procedures. One of these newer procedures is a transforaminal lumbar interbody fusion (TLIF). It is a minimally invasive technique to fuse the spine, reduce the recovery period, and post-operative complications.
The procedure begins with the patient lying on their stomach, and a small incision is made along side the spine. This approach allows the surgeon to remove a portion of facet joint, allowing surgical access to the disc between the two vertebrae. A large portion of the disc is removed, and the area between the vertebral bodies is prepared for the fusion.
Surgical hardware, which includes pedicle screws and rods, are then attached to the vertebrae, providing alignment and stabilization. An interbody spacer is then fitted into the disc space along with bone graft. The spacer performs the dual purpose of maintaining intervertebral disc height and containing the bone. Increasing disc height helps create more space for the nerves, thus reducing symptoms of spinal stenosis.
As the graft heals, it eventually creates a bone bridge between the two vertebrae. This results in the fused vertebras acting as one, eliminating the painful motion between the vertebras.
Fusion surgery can be extremely beneficial. Certain back conditions such as spondylolisthesis — a condition where one vertebra slides over the vertebra below, pinching the spinal cord or nerve roots — is one condition that can be resolved with the TLIF procedure. Other reasons for vertebral fusion are recurrent disc herniations, unstable vertebra, and destabilizing spinal cord and nerve root decompressions.
The minimally invasive TLIF has significant advantages over traditional forms of spinal fusion — smaller incisions and shorter recovery times with all the benefits of a TLIF procedure are just a few.
According to Dr. Kukkar, 85 percent of the spinal surgeries performed in America are still done in the traditional way, meaning the advantages of minimally invasive techniques such as the TLIF are not being employed in most places.
If you’re suffering from back pain and wondering if TLIF might be an option for you, consult a specialist who can determine the proper course of treatment.
read about some firsthand experiences of people who have undergone the TLIF procedure here in Central Illinois.
Dr. Kukkar is currently one of the few surgeons in all of Central Illinois who has been trained in and is qualified to perform the TLIF procedure. For more information or to set up an appointment, you may contact him at the Orthopedic & Sports Enhancement Center, 309-663-9300. Their office is located at 2406 E. Empire St. in Bloomington.
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