A transforaminal lumbar interbody fusion (TLIF) is performed to remove a portion of a disc that is the source of back or legpain and fuse the spine. Like the PLIF (posterior lumbar interbody fusion) procedure, bone graft is used to fuse thespinal vertebrae after the disc isremoved.
However, the TLIF procedure places a single bone graft between the vertebrae from the side, rather than two bone grafts from the rear as in the PLIFprocedure. In patients with spinal instability, instrumentation is used to help stabilize the spine during the bone graft fusion.
Using a technique known as minimally invasive surgery, this procedure can be done with a muchsmaller incision than traditional open spinal surgeries and decreases damage to the lower back muscles
A transforaminal lumbar interbody fusion (TLIF) is performed toremove a portion of a disc that is the source of back or leg painand fuse the spine. Like the PLIF (posterior lumbar interbodyfusion) procedure, bone graft is used to fuse the spinal vertebraeafter the disc is removed. However, the TLIF procedure places asingle bone graft between the vertebrae from the side, rather thantwo bone grafts from the rear as in the PLIF procedure. In patientswith spinal instability, instrumentation is used to help stabilize thespine during the bone graft fusion. Using a technique known asminimally invasive surgery, this procedure can be done with amuch smaller incision than traditional open spinal surgeries anddecreases damage to the low back muscles
A short incision, approximately 2.5 cm. (1 in.), is made to the sideof the middle of the lower back. A device that projects live X-rayimages onto a screen, called a fluoroscope is typically used topinpoint the exact position on the spine where the surgery will beperformed. Next, a thin wire or needle is inserted through tissuesand muscle to the level of the spine. Special dilators are guideddown the wire to separate muscle fibers and provide access to theunderlying spine without cutting through the muscles. After theinitial dilator is docked on the back of the spine, larger dilators areadded, gradually increasing the diameter to allow enough room forthe surgical procedure
A retractor device that can expand the surgical field and hold backthe muscle is placed over the dilators. The dilators are removedand a lighting component is attached to illuminate the surgicalfield. A hex screwdriver is used to open the retractor blades,holding the soft tissue out of the way. The surgical exposure isnow complete. An endoscope or microscope is then added to theedge of the retractor to provide close-up imagery on a screen tohelp guide the procedure.
Through the opening in the retractor, the surgeon is now able toremove the entire facet joint in order to allow access to the disc.Removing bone here allows the surgeon to access the disc
A grasping instrument is used to remove most of the intervertebraldisc. Removing the facet joints and disc relieves pressure on thespinal nerves.
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